Provider Demographics
NPI:1235120007
Name:FOX-THOMAS, LISA G I (PHD, CCC-A)
Entity Type:Individual
Prefix:DR
First Name:LISA
Middle Name:G
Last Name:FOX-THOMAS
Suffix:I
Gender:F
Credentials:PHD, CCC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:524 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27412-6170
Mailing Address - Country:US
Mailing Address - Phone:336-334-5939
Mailing Address - Fax:336-334-4475
Practice Address - Street 1:300 FERGUSON BLDG
Practice Address - Street 2:UNC-GREENSBORO
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27402-6170
Practice Address - Country:US
Practice Address - Phone:336-334-5939
Practice Address - Fax:336-334-4475
Is Sole Proprietor?:No
Enumeration Date:2005-11-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6712231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7412291Medicaid
NC6712OtherNC BOARD OF EXAMINERS FOR
NC1126OtherN C STATE HEARING AID DEA
NC13876Medicare UPIN