Provider Demographics
NPI:1497220933
Name:COX, DARLENE M (LPC)
Entity Type:Individual
Prefix:
First Name:DARLENE
Middle Name:M
Last Name:COX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:NA
Other - Middle Name:
Other - Last Name:NA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PLPC
Mailing Address - Street 1:1934 DANDELION DR
Mailing Address - Street 2:
Mailing Address - City:PACIFIC
Mailing Address - State:MO
Mailing Address - Zip Code:63069-1106
Mailing Address - Country:US
Mailing Address - Phone:636-432-6436
Mailing Address - Fax:
Practice Address - Street 1:220 S 1ST ST OFC 6
Practice Address - Street 2:
Practice Address - City:PACIFIC
Practice Address - State:MO
Practice Address - Zip Code:63069-2164
Practice Address - Country:US
Practice Address - Phone:636-432-6436
Practice Address - Fax:636-582-1783
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018036504101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO490061901Medicaid