Provider Demographics
NPI:1710493564
Name:TREADWELL COX, HATTIE (NCC, LPC)
Entity Type:Individual
Prefix:
First Name:HATTIE
Middle Name:
Last Name:TREADWELL COX
Suffix:
Gender:F
Credentials:NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6112 W DIVERSEY AVE UNIT D-1
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60639-1186
Mailing Address - Country:US
Mailing Address - Phone:773-349-7956
Mailing Address - Fax:
Practice Address - Street 1:3936 W ROOSEVELT RD STE 201
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60624-4389
Practice Address - Country:US
Practice Address - Phone:773-826-0398
Practice Address - Fax:773-826-2327
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-15
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)