Provider Demographics
NPI:1508864778
Name:COX, MARYANN H (LCSW)
Entity Type:Individual
Prefix:
First Name:MARYANN
Middle Name:H
Last Name:COX
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 1:5700 W GRACE ST
Mailing Address - Street 2:#104
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-1832
Mailing Address - Country:US
Mailing Address - Phone:804-359-2424
Mailing Address - Fax:804-359-0029
Practice Address - Street 1:5700 W GRACE ST
Practice Address - Street 2:#104
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-1832
Practice Address - Country:US
Practice Address - Phone:804-359-2424
Practice Address - Fax:804-359-0029
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-12
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040012071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
2092709OtherCIGNA
222497OtherMHN
226658000OtherMAGELLAN
4347036OtherAETNA
88817OtherOPTIMA BEHAVIORAL HEALTH
541603308OtherAETNA
62590592OtherUNITED BEHAVIORAL HEALTH
800000586OtherMEDICARE
861112647OtherUNITED BEHAVIORAL HEALTH
4149737OtherMAMSI
31859OtherVALUE OPTIONS
031859OtherVALUE OPTIONS
086581OtherSENTARA BEHAVIORAL HEALTH SERVICES
083159OtherANTHEM
145069OtherANTHEM
303527OtherANTHEM
541603308OtherTRICARE