Provider Demographics
NPI:1740991793
Name:COX, CAMERON BRADLEY (CSW)
Entity type:Individual
Prefix:
First Name:CAMERON
Middle Name:BRADLEY
Last Name:COX
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 S 500 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-2705
Mailing Address - Country:US
Mailing Address - Phone:801-808-3130
Mailing Address - Fax:
Practice Address - Street 1:5965 S 900 E STE 100
Practice Address - Street 2:
Practice Address - City:MURRAY
Practice Address - State:UT
Practice Address - Zip Code:84121-1850
Practice Address - Country:US
Practice Address - Phone:801-808-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-12
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12860003-35021041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical