Provider Demographics
NPI:1023452646
Name:COX, JANICE K
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:K
Last Name:COX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1807 W SIENNA BOUQUET PL
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85085-8042
Mailing Address - Country:US
Mailing Address - Phone:480-640-7988
Mailing Address - Fax:480-546-3728
Practice Address - Street 1:1807 W SIENNA BOUQUET PL
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85085-8042
Practice Address - Country:US
Practice Address - Phone:480-640-7988
Practice Address - Fax:480-546-3728
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-25
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
AZLPC-18823101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ091621Medicaid