Provider Demographics
NPI:1407872278
Name:COX-WAITHE, MONIQUE A (LCSW)
Entity Type:Individual
Prefix:
First Name:MONIQUE
Middle Name:A
Last Name:COX-WAITHE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10955 WINDS CROSSING DR STE 300
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273-6778
Mailing Address - Country:US
Mailing Address - Phone:704-343-6511
Mailing Address - Fax:
Practice Address - Street 1:10955 WINDS CROSSING DR STE 300
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273-6778
Practice Address - Country:US
Practice Address - Phone:704-343-6511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-14
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0051181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106207Medicaid