Provider Demographics
NPI:1124754700
Name:COX, VIRGINIA BLAKE (LPC-A)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:BLAKE
Last Name:COX
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1069 MARSH COURT LN
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:SC
Mailing Address - Zip Code:29464-3356
Mailing Address - Country:US
Mailing Address - Phone:180-380-7653
Mailing Address - Fax:
Practice Address - Street 1:4 CARRIAGE LN
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29407-6065
Practice Address - Country:US
Practice Address - Phone:800-552-4357
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-27
Last Update Date:2024-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health