Provider Demographics
NPI:1396992657
Name:COX, KEVIN P (BA CSAC)
Entity type:Individual
Prefix:
First Name:KEVIN
Middle Name:P
Last Name:COX
Suffix:
Gender:M
Credentials:BA CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N3152 HWY 81
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WI
Mailing Address - Zip Code:53566-8821
Mailing Address - Country:US
Mailing Address - Phone:608-328-9303
Mailing Address - Fax:608-328-9480
Practice Address - Street 1:N3152 HWY 81
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WI
Practice Address - Zip Code:53566-8821
Practice Address - Country:US
Practice Address - Phone:608-328-9303
Practice Address - Fax:608-328-9480
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)