Provider Demographics
NPI:1134567985
Name:COXEN, JILL (LPC)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:COXEN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 50402
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85076-0402
Mailing Address - Country:US
Mailing Address - Phone:480-203-0928
Mailing Address - Fax:
Practice Address - Street 1:11010 S 51ST ST
Practice Address - Street 2:# 50402
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85044-4311
Practice Address - Country:US
Practice Address - Phone:480-203-0928
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-13
Last Update Date:2013-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ14255101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
14255OtherAZ LPC