Provider Demographics
NPI:1538499637
Name:COX, PATRICE LATONYA (LPC)
Entity type:Individual
Prefix:MRS
First Name:PATRICE
Middle Name:LATONYA
Last Name:COX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 NORTH AVE
Mailing Address - Street 2:SUITE K
Mailing Address - City:JONESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30236-8405
Mailing Address - Country:US
Mailing Address - Phone:678-604-7020
Mailing Address - Fax:404-601-7530
Practice Address - Street 1:118 NORTH AVE
Practice Address - Street 2:SUITE K
Practice Address - City:JONESBORO
Practice Address - State:GA
Practice Address - Zip Code:30236-8405
Practice Address - Country:US
Practice Address - Phone:678-604-7020
Practice Address - Fax:404-601-7530
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC005841101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA628495412AMedicaid