Provider Demographics
NPI:1639447220
Name:COX, AMBER
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 E MARKET STREET
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902
Mailing Address - Country:US
Mailing Address - Phone:703-496-7804
Mailing Address - Fax:540-898-1040
Practice Address - Street 1:9274 CORPORATE CIR
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4153
Practice Address - Country:US
Practice Address - Phone:703-496-7804
Practice Address - Fax:540-898-1040
Is Sole Proprietor?:No
Enumeration Date:2011-12-09
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3367101YP2500X
MDLC3702101YP2500X
VA0701007179101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional