Provider Demographics
NPI:1639440605
Name:COX, ANNE L (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:L
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:HC 88 BOX 455
Mailing Address - Street 2:
Mailing Address - City:POCONO LAKE
Mailing Address - State:PA
Mailing Address - Zip Code:18347-9612
Mailing Address - Country:US
Mailing Address - Phone:570-355-5469
Mailing Address - Fax:
Practice Address - Street 1:359 S.MOUNTAINTOP BOULEVARD
Practice Address - Street 2:SUITE C-2
Practice Address - City:MOUNTAINTOP
Practice Address - State:PA
Practice Address - Zip Code:18707
Practice Address - Country:US
Practice Address - Phone:570-403-5080
Practice Address - Fax:570-403-5079
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2012-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0171961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical