Provider Demographics
NPI:1831450238
Name:COX, KATHRYN JEMISON (LISW-S)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:JEMISON
Last Name:COX
Suffix:
Gender:F
Credentials:LISW-S
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LOUISE
Other - Last Name:JEMISON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:736 RIDGEVIEW DR
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-7448
Mailing Address - Country:US
Mailing Address - Phone:614-519-3375
Mailing Address - Fax:
Practice Address - Street 1:736 RIDGEVIEW DR
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-7448
Practice Address - Country:US
Practice Address - Phone:614-519-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-01
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00050891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical