Provider Demographics
NPI:1942272125
Name:COX, DALE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2396 NW KINGS BLVD
Mailing Address - Street 2:STE 201
Mailing Address - City:CORVALLIS
Mailing Address - State:OR
Mailing Address - Zip Code:97330-3984
Mailing Address - Country:US
Mailing Address - Phone:541-487-7364
Mailing Address - Fax:
Practice Address - Street 1:2396 NW KINGS BLVD
Practice Address - Street 2:STE 201
Practice Address - City:CORVALLIS
Practice Address - State:OR
Practice Address - Zip Code:97330-3984
Practice Address - Country:US
Practice Address - Phone:541-231-8343
Practice Address - Fax:888-772-2445
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2017-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORL04591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical