Provider Demographics
NPI:1699240580
Name:COX, ANGELA (MSW, LGSW)
Entity type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:COX
Suffix:
Gender:F
Credentials:MSW, LGSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19675 ESTES PATH
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:MN
Mailing Address - Zip Code:55024-7201
Mailing Address - Country:US
Mailing Address - Phone:651-447-3091
Mailing Address - Fax:
Practice Address - Street 1:VAMC MINNEAPOLIS
Practice Address - Street 2:1 VETERANS DRIVE (1K)
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55417
Practice Address - Country:US
Practice Address - Phone:651-447-3091
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN276101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical