Provider Demographics
NPI:1902078934
Name:COX, SHANDRE' K. COX K (LPC, LCSW, LICSW)
Entity type:Individual
Prefix:
First Name:SHANDRE' K. COX
Middle Name:K
Last Name:COX
Suffix:
Gender:F
Credentials:LPC, LCSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 346
Mailing Address - Street 2:
Mailing Address - City:LAKE
Mailing Address - State:MS
Mailing Address - Zip Code:39092-0346
Mailing Address - Country:US
Mailing Address - Phone:601-880-3879
Mailing Address - Fax:
Practice Address - Street 1:103 S 19TH AVE
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-6171
Practice Address - Country:US
Practice Address - Phone:601-544-4641
Practice Address - Fax:601-584-4053
Is Sole Proprietor?:No
Enumeration Date:2008-03-31
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS1348101Y00000X
CA959221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor