Provider Demographics
NPI:1205542024
Name:COX, DAVID LYNN
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:LYNN
Last Name:COX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1611 CASTLE HAYNE RD BLDG C
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28401-8859
Mailing Address - Country:US
Mailing Address - Phone:910-251-6644
Mailing Address - Fax:
Practice Address - Street 1:1611 CASTLE HAYNE RD BLDG C
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28401-8859
Practice Address - Country:US
Practice Address - Phone:910-251-6644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-25
Last Update Date:2023-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCADC-22758101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)