Provider Demographics
NPI:1942933890
Name:COX, NATASHA (CADAC II)
Entity Type:Individual
Prefix:
First Name:NATASHA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:CADAC II
Other - Prefix:
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:KINNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KINNICK
Mailing Address - Street 1:510 GRAND VALLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46151-5883
Mailing Address - Country:US
Mailing Address - Phone:765-558-2727
Mailing Address - Fax:765-349-7688
Practice Address - Street 1:1053 PINEWOOD DR
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-2421
Practice Address - Country:US
Practice Address - Phone:317-767-1866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-07
Last Update Date:2023-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INC2-5134101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)