Provider Demographics
NPI:1366744591
Name:COX, ANDREA AGUERO (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:AGUERO
Last Name:COX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:ANDREA
Other - Middle Name:MARIE
Other - Last Name:AGUERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4113 BIRDWELL DR
Mailing Address - Street 2:
Mailing Address - City:TYLER
Mailing Address - State:TX
Mailing Address - Zip Code:75703-1606
Mailing Address - Country:US
Mailing Address - Phone:903-283-4405
Mailing Address - Fax:
Practice Address - Street 1:4113 BIRDWELL DR
Practice Address - Street 2:
Practice Address - City:TYLER
Practice Address - State:TX
Practice Address - Zip Code:75703-1606
Practice Address - Country:US
Practice Address - Phone:903-283-4405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-19
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX381091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical