Provider Demographics
NPI:1093791501
Name:FOX, WINIFRED ELLEN (PHD LMFT, LPC)
Entity Type:Individual
Prefix:DR
First Name:WINIFRED
Middle Name:ELLEN
Last Name:FOX
Suffix:
Gender:F
Credentials:PHD LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100B STADIUM OAKS DR
Mailing Address - Street 2:
Mailing Address - City:CLEMMONS
Mailing Address - State:NC
Mailing Address - Zip Code:27012-8961
Mailing Address - Country:US
Mailing Address - Phone:336-365-5205
Mailing Address - Fax:
Practice Address - Street 1:100B STADIUM OAKS DR
Practice Address - Street 2:
Practice Address - City:CLEMMONS
Practice Address - State:NC
Practice Address - Zip Code:27012
Practice Address - Country:US
Practice Address - Phone:336-365-5205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCLMFT 805, LPC 2475106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist