Provider Demographics
NPI:1235027392
Name:FOX, MICHELLE (SACIT)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:SACIT
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:
Other - Last Name:HAUMSCHILD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SACIT
Mailing Address - Street 1:310 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:FORT ATKINSON
Mailing Address - State:WI
Mailing Address - Zip Code:53538-1749
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2914 INDUSTRIAL DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53713-4047
Practice Address - Country:US
Practice Address - Phone:608-223-3319
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI20397-130101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)