Provider Demographics
NPI:1578729513
Name:COX, KELLY ANN (LCSW)
Entity Type:Individual
Prefix:MISS
First Name:KELLY
Middle Name:ANN
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 1:300 PRESTON AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-5044
Mailing Address - Country:US
Mailing Address - Phone:434-293-4262
Mailing Address - Fax:434-293-3077
Practice Address - Street 1:300 PRESTON AVE STE 206
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-5044
Practice Address - Country:US
Practice Address - Phone:434-293-4262
Practice Address - Fax:434-293-3077
Is Sole Proprietor?:No
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040067921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical