Provider Demographics
NPI:1407225667
Name:FOX, DALE A (MA COUNSELING)
Entity Type:Individual
Prefix:MR
First Name:DALE
Middle Name:A
Last Name:FOX
Suffix:
Gender:M
Credentials:MA COUNSELING
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 HENRY LOVING ST.
Mailing Address - Street 2:P.O. BOX 148
Mailing Address - City:ANSTED
Mailing Address - State:WV
Mailing Address - Zip Code:25812-0148
Mailing Address - Country:US
Mailing Address - Phone:304-640-1622
Mailing Address - Fax:
Practice Address - Street 1:120 HARPER CT
Practice Address - Street 2:
Practice Address - City:BECKLEY
Practice Address - State:WV
Practice Address - Zip Code:25801-2650
Practice Address - Country:US
Practice Address - Phone:304-255-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-17
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1628101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional