Provider Demographics
NPI:1467664912
Name:COX, SEAN PATRICK (LCPC)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:PATRICK
Last Name:COX
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1628 W COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60626-4111
Mailing Address - Country:US
Mailing Address - Phone:773-262-4631
Mailing Address - Fax:773-913-2205
Practice Address - Street 1:2000 N RACINE AVE
Practice Address - Street 2:2300
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60614-4045
Practice Address - Country:US
Practice Address - Phone:773-262-4631
Practice Address - Fax:773-913-2205
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional