Provider Demographics
NPI:1538843578
Name:COX, NATHAN
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:COX
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2116 COUNTY ROUTE 5
Mailing Address - Street 2:
Mailing Address - City:BRUSHTON
Mailing Address - State:NY
Mailing Address - Zip Code:12916-3817
Mailing Address - Country:US
Mailing Address - Phone:518-353-2586
Mailing Address - Fax:
Practice Address - Street 1:6604 STATE ROUTE 56
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676
Practice Address - Country:US
Practice Address - Phone:315-439-9930
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY12567-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker