Provider Demographics
NPI:1770524936
Name:COX, PAUL R (LSCSW)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:R
Last Name:COX
Suffix:
Gender:M
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3212 SW ATWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-2842
Mailing Address - Country:US
Mailing Address - Phone:785-843-2429
Mailing Address - Fax:785-843-7386
Practice Address - Street 1:3510 CLINTON PL
Practice Address - Street 2:SUITE 320
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2195
Practice Address - Country:US
Practice Address - Phone:785-843-2429
Practice Address - Fax:785-843-7386
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2010-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW2212104100000X
MOLCSW000213104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS069541Medicare ID - Type Unspecified
R30452Medicare UPIN