Provider Demographics
NPI:1962505156
Name:AP WILLCOX INC
Entity Type:Organization
Organization Name:AP WILLCOX INC
Other - Org Name:A PAUL WILLCOX LCSW DCSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER IN PRIV PRAC
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:WILLCOX
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:318-222-6226
Mailing Address - Street 1:1002 HIGHLAND AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71101-4143
Mailing Address - Country:US
Mailing Address - Phone:318-222-6226
Mailing Address - Fax:318-222-6227
Practice Address - Street 1:1002 HIGHLAND AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71101-4143
Practice Address - Country:US
Practice Address - Phone:318-222-6226
Practice Address - Fax:318-222-6227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA26561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LAG4291OtherBLUE CROSS BLUE SHIELD
LAG4291OtherBLUE CROSS BLUE SHIELD