Provider Demographics
NPI:1740893882
Name:COX, BERNADETTE (LGPC)
Entity type:Individual
Prefix:
First Name:BERNADETTE
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:607 7TH ST APT 402
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4095
Mailing Address - Country:US
Mailing Address - Phone:301-755-3970
Mailing Address - Fax:
Practice Address - Street 1:11720 BELTSVILLE DR STE 500-A4
Practice Address - Street 2:
Practice Address - City:BELTSVILLE
Practice Address - State:MD
Practice Address - Zip Code:20705-3166
Practice Address - Country:US
Practice Address - Phone:240-755-8089
Practice Address - Fax:202-217-4444
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP10746101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional