Provider Demographics
NPI:1760099006
Name:COX, ROZALYN NICOLE (PORVISIONAL LMSW)
Entity Type:Individual
Prefix:MRS
First Name:ROZALYN
Middle Name:NICOLE
Last Name:COX
Suffix:
Gender:F
Credentials:PORVISIONAL LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 19000
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88102-9000
Mailing Address - Country:US
Mailing Address - Phone:575-769-4490
Mailing Address - Fax:575-769-4330
Practice Address - Street 1:1600 SUTTER PL
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-4611
Practice Address - Country:US
Practice Address - Phone:575-769-4490
Practice Address - Fax:575-769-4330
Is Sole Proprietor?:No
Enumeration Date:2020-09-30
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMSWB-2023-06441041C0700X
NMX-115151041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool