Provider Demographics
NPI:1740673110
Name:COX, SHIRLEY ELIZABETH (PHD, DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:SHIRLEY
Middle Name:ELIZABETH
Last Name:COX
Suffix:
Gender:F
Credentials:PHD, DSW, LCSW
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 971534
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84097-1534
Mailing Address - Country:US
Mailing Address - Phone:801-376-6058
Mailing Address - Fax:801-422-0624
Practice Address - Street 1:3585 N UNIVERSITY AVE STE 350
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-6608
Practice Address - Country:US
Practice Address - Phone:801-376-6058
Practice Address - Fax:801-422-0624
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-10
Last Update Date:2015-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12542235011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical