Provider Demographics
NPI:1073634630
Name:FOX, TOVA (LPCC, LADAC)
Entity Type:Individual
Prefix:MS
First Name:TOVA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:LPCC, LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 17TH ST NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87104-1307
Mailing Address - Country:US
Mailing Address - Phone:505-242-4400
Mailing Address - Fax:505-242-4595
Practice Address - Street 1:500 17TH ST NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87104-1307
Practice Address - Country:US
Practice Address - Phone:505-242-4400
Practice Address - Fax:505-242-4595
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2009-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0105021101YP2500X
NM0103021101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)