Basic Information
Provider Information
NPI: 1023664810
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COX
FirstName: JOSEPH
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 118 N 2ND ST STE 200
Address2:  
City: SAINT CHARLES
State: MO
PostalCode: 633012894
CountryCode: US
TelephoneNumber: 6362241210
FaxNumber:  
Practice Location
Address1: 900 E LAHARPE ST
Address2:  
City: KIRKSVILLE
State: MO
PostalCode: 635014520
CountryCode: US
TelephoneNumber: 6606651962
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/16/2019
LastUpdateDate: 11/04/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/04/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YP2500X2019029616MOY Behavioral Health & Social Service ProvidersCounselorProfessional
101Y00000X  N Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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