Provider Demographics
NPI:1639691074
Name:COX, JENNIFER LEAH (LPC)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:LEAH
Last Name:COX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JEN
Other - Middle Name:
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LPC
Mailing Address - Street 1:205 RALEIGH DR
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-2103
Mailing Address - Country:US
Mailing Address - Phone:478-542-1334
Mailing Address - Fax:
Practice Address - Street 1:205 RALEIGH DR
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-2103
Practice Address - Country:US
Practice Address - Phone:478-542-1334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-07
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GALPC013021101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program