Provider Demographics
NPI:1073813440
Name:FOX, STEPHANIE LAUREL (MS)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:LAUREL
Last Name:FOX
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 WASHINGTON ST
Mailing Address - Street 2:APT 4
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3658
Mailing Address - Country:US
Mailing Address - Phone:917-841-6245
Mailing Address - Fax:
Practice Address - Street 1:35 CONGRESS ST
Practice Address - Street 2:SUITE 214
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-5529
Practice Address - Country:US
Practice Address - Phone:978-542-1951
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health