Provider Demographics
NPI:1952793903
Name:COX, SIMONE (LPC)
Entity Type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 BRISBANE DR
Mailing Address - Street 2:
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-7713
Mailing Address - Country:US
Mailing Address - Phone:770-510-6945
Mailing Address - Fax:
Practice Address - Street 1:2450 PIEDMONT RD NE STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3569
Practice Address - Country:US
Practice Address - Phone:770-510-6945
Practice Address - Fax:770-217-3177
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-28
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA008216101YP2500X
GA001419106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist