Provider Demographics
NPI:1417113663
Name:FOX, PATRICK J (BA)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:J
Last Name:FOX
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 KESSEL COURT STE 105
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53703-2637
Mailing Address - Country:US
Mailing Address - Phone:608-280-2700
Mailing Address - Fax:608-280-2705
Practice Address - Street 1:2000 FORDEM AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53704-2637
Practice Address - Country:US
Practice Address - Phone:608-280-2740
Practice Address - Fax:608-280-2705
Is Sole Proprietor?:No
Enumeration Date:2008-08-06
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor