Individual provider Active NPI

Candice Evetta Cox, LCSW

  • Clinical Social Worker
  • Saint Louis, MO
National Provider Identifier
1598081887
Registry record updated Apr 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3636-C Issued in AR
Practice address
8790 Manchester Rd Ste 205a
Saint Louis, MO 63144-2707
Phone
(314) 898-6541
Fax
(314) 558-8448
NPI assigned
Apr 13, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 22, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3636-C AR Primary

Addresses

Primary practice location

8790 Manchester Rd Ste 205a
Saint Louis, MO 63144-2707

Mailing address

8790 Manchester Rd Ste 205a
Saint Louis, MO 63144-2707
Phone (314) 898-6541

Other practice location 1

1627 El Tigre Ter
Saint Louis, MO 63138-1807
Phone (314) 874-7410

Other identifiers 1

IdentifierTypeStateIssuer
1033541347MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3636-CARMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1271116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555891200000",
    "number": "1598081887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8790 MANCHESTER RD STE 205A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442707",
            "telephone_number": "314-898-6541",
            "fax_number": "314-558-8448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8790 MANCHESTER RD STE 205A",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631442707",
            "telephone_number": "314-898-6541",
            "fax_number": "314-558-8448"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1627 El Tigre Ter",
            "address_purpose": "LOCATION",
            "city": "Saint Louis",
            "state": "MO",
            "postal_code": "631381807",
            "country_code": "US",
            "telephone_number": "314-874-7410",
            "fax_number": "314-874-7410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COX",
        "first_name": "CANDICE",
        "middle_name": "EVETTA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-13",
        "last_updated": "2019-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "AR",
            "license": "3636-C",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1033541347",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.