Provider Demographics
NPI:1558308981
Name:COX, JENNIFER TEMPLETON (PSYD, LCSW)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:TEMPLETON
Last Name:COX
Suffix:
Gender:F
Credentials:PSYD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 ZORN AVENUE
Mailing Address - Street 2:ROBLEY REX VA HOSPITAL
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40206
Mailing Address - Country:US
Mailing Address - Phone:502-287-6984
Mailing Address - Fax:502-895-6883
Practice Address - Street 1:800 ZORN AVENUE
Practice Address - Street 2:ROBLEY REX VA HOSPITAL
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206
Practice Address - Country:US
Practice Address - Phone:502-287-6984
Practice Address - Fax:502-895-6883
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2013-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1711103TC0700X
MO20040337401041C0700X
KY34291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical