Provider Demographics
NPI:1124655329
Name:COX, EDWARD MARTIN III
Entity type:Individual
Prefix:MR
First Name:EDWARD
Middle Name:MARTIN
Last Name:COX
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 E DICKENSON PL
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222-6012
Mailing Address - Country:US
Mailing Address - Phone:303-504-6517
Mailing Address - Fax:303-758-5793
Practice Address - Street 1:4141 E DICKENSON PL
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6012
Practice Address - Country:US
Practice Address - Phone:303-504-6517
Practice Address - Fax:303-758-5793
Is Sole Proprietor?:No
Enumeration Date:2020-03-26
Last Update Date:2024-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0002437101YA0400X
CO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health