Provider Demographics
NPI:1255858759
Name:COX, YANIQUE SHENEQUA
Entity Type:Individual
Prefix:
First Name:YANIQUE
Middle Name:SHENEQUA
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:555 BERGEN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10455-1368
Mailing Address - Country:US
Mailing Address - Phone:845-743-6704
Mailing Address - Fax:718-993-4345
Practice Address - Street 1:555 BERGEN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10455-1368
Practice Address - Country:US
Practice Address - Phone:845-743-6704
Practice Address - Fax:718-993-4345
Is Sole Proprietor?:No
Enumeration Date:2017-08-25
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NY100229-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health