Provider Demographics
NPI:1336114347
Name:COX, PRINCA E (LPC)
Entity Type:Individual
Prefix:
First Name:PRINCA
Middle Name:E
Last Name:COX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:895 STATE FARM RD
Mailing Address - Street 2:SUITE 508
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-4917
Mailing Address - Country:US
Mailing Address - Phone:828-264-9007
Mailing Address - Fax:828-262-5687
Practice Address - Street 1:1650 HIGHWAY 18 SOUTH
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:NC
Practice Address - Zip Code:28675-8478
Practice Address - Country:US
Practice Address - Phone:336-372-4095
Practice Address - Fax:828-262-5687
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4115101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
1335NOtherBLUECROSS BLUESHIELD
NCN/AOtherMHNET
NC6102768Medicaid
NCC5020OtherMEDCOST