Provider Demographics
NPI:1164016085
Name:FOXFIRE COUNSELING LLC
Entity Type:Organization
Organization Name:FOXFIRE COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KIT
Authorized Official - Middle Name:
Authorized Official - Last Name:CORPS
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:260-267-5595
Mailing Address - Street 1:3262 MALLARD COVE LN STE C
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-2883
Mailing Address - Country:US
Mailing Address - Phone:260-267-5595
Mailing Address - Fax:
Practice Address - Street 1:3262 MALLARD COVE LN STE C
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2883
Practice Address - Country:US
Practice Address - Phone:260-267-5595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-22
Last Update Date:2021-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty