Provider Demographics
NPI:1346437860
Name:FOX, DANNY WAYNE (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DANNY
Middle Name:WAYNE
Last Name:FOX
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:CORP 1485 S. SEMORAN BLVD., SUITE 1448
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FLORIDA
Mailing Address - Zip Code:32792
Mailing Address - Country:UM
Mailing Address - Phone:321-397-3000
Mailing Address - Fax:
Practice Address - Street 1:1409 NW 36TH PL
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32605-2555
Practice Address - Country:US
Practice Address - Phone:352-334-0880
Practice Address - Fax:352-334-0883
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN56811041C0700X
FLSW-35661041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLET833AMedicare UPIN