Provider Demographics
NPI:1497939797
Name:COX, DAVID WAYNE (LCSW,LMFT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:WAYNE
Last Name:COX
Suffix:
Gender:M
Credentials:LCSW,LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 PICKENS ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3448
Mailing Address - Country:US
Mailing Address - Phone:803-765-9944
Mailing Address - Fax:803-799-6267
Practice Address - Street 1:1513 PICKENS ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3448
Practice Address - Country:US
Practice Address - Phone:803-765-9944
Practice Address - Fax:803-799-6267
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2007-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34000042A1041C0700X
IN35000036A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist