Provider Demographics
NPI:1518092592
Name:COX, HOLLY A (LCPC)
Entity Type:Individual
Prefix:MS
First Name:HOLLY
Middle Name:A
Last Name:COX
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19015 S JODI RD
Mailing Address - Street 2:UNIT H
Mailing Address - City:MOKENA
Mailing Address - State:IL
Mailing Address - Zip Code:60448-8514
Mailing Address - Country:US
Mailing Address - Phone:708-717-5327
Mailing Address - Fax:
Practice Address - Street 1:19015 S JODI RD
Practice Address - Street 2:UNIT H
Practice Address - City:MOKENA
Practice Address - State:IL
Practice Address - Zip Code:60448-8514
Practice Address - Country:US
Practice Address - Phone:708-717-5327
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
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