Provider Demographics
NPI:1790918845
Name:COX, SHELLY JEAN (LPC)
Entity Type:Individual
Prefix:MS
First Name:SHELLY
Middle Name:JEAN
Last Name:COX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1020 8TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-1101
Mailing Address - Country:US
Mailing Address - Phone:970-350-6730
Mailing Address - Fax:970-350-6515
Practice Address - Street 1:1020 8TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-1101
Practice Address - Country:US
Practice Address - Phone:970-350-6730
Practice Address - Fax:970-350-6515
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-24
Last Update Date:2009-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO4409101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional