Provider Demographics
NPI:1376882381
Name:FOX, JONATHAN HILLEL (LMFT)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:HILLEL
Last Name:FOX
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1711 WILLAMETTE STREET STE 301
Mailing Address - Street 2:#234
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-4593
Mailing Address - Country:US
Mailing Address - Phone:707-782-2857
Mailing Address - Fax:
Practice Address - Street 1:492 EAST 13TH AVE STE 3
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401
Practice Address - Country:US
Practice Address - Phone:458-215-1454
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-11
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA90115106H00000X
ORT2211106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist