Provider Demographics
NPI:1982288403
Name:COX, TYLER JAMES (MSW)
Entity Type:Individual
Prefix:
First Name:TYLER
Middle Name:JAMES
Last Name:COX
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:505 N PARKVIEW ST
Mailing Address - Street 2:
Mailing Address - City:COFFEYVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:67337-1120
Mailing Address - Country:US
Mailing Address - Phone:620-515-5417
Mailing Address - Fax:
Practice Address - Street 1:1101 DONALD AVE
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:KS
Practice Address - Zip Code:67301-2001
Practice Address - Country:US
Practice Address - Phone:620-331-3131
Practice Address - Fax:620-332-5100
Is Sole Proprietor?:No
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12081104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker