Provider Demographics
NPI:1821460528
Name:COX, MARK (CMHC)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:CMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1045 S. OREN BLVD.
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84058-1700
Mailing Address - Country:US
Mailing Address - Phone:801-875-2892
Mailing Address - Fax:801-223-2254
Practice Address - Street 1:1045 S. OREN BLVD.
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84058-1700
Practice Address - Country:US
Practice Address - Phone:801-875-2892
Practice Address - Fax:801-223-2254
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT7405332-6004101YP2500X
WYLPC-1305101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty