Provider Demographics
NPI:1164100558
Name:FOX, ERIK V (PLPC)
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:V
Last Name:FOX
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 PFEIFFER AVE
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-5047
Mailing Address - Country:US
Mailing Address - Phone:660-665-4612
Mailing Address - Fax:660-665-4635
Practice Address - Street 1:105 PFEIFFER AVE
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-5047
Practice Address - Country:US
Practice Address - Phone:660-665-4612
Practice Address - Fax:660-665-4635
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-06
Last Update Date:2023-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023022520101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional