Provider Demographics
NPI:1649751496
Name:COX, CODY MARK (ACMHC)
Entity type:Individual
Prefix:MR
First Name:CODY
Middle Name:MARK
Last Name:COX
Suffix:
Gender:M
Credentials:ACMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2069 N MAIN ST STE 101
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-5602
Mailing Address - Country:US
Mailing Address - Phone:435-215-1775
Mailing Address - Fax:
Practice Address - Street 1:2069 N MAIN ST STE 101
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-5602
Practice Address - Country:US
Practice Address - Phone:435-215-1775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health