Provider Demographics
NPI:1336294610
Name:FOX, ROBERT (LMHC, LADC I, CEAP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:LMHC, LADC I, CEAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MALL RD STE 301
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-4131
Mailing Address - Country:US
Mailing Address - Phone:781-933-0200
Mailing Address - Fax:781-933-0301
Practice Address - Street 1:10 MALL RD STE 301
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-4131
Practice Address - Country:US
Practice Address - Phone:781-933-0200
Practice Address - Fax:781-933-0301
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2135101YA0400X
MA5333101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MALM1123OtherBLUE CROSS-BLUE SHIELD ID
MA2135OtherLICENSED ALCOHOL AND DRUG
MA5333OtherLMHC LICENSE NUMBER