Provider Demographics
NPI:1538634530
Name:KATIE J. FOX, MSW, LICSW, PLLC
Entity Type:Organization
Organization Name:KATIE J. FOX, MSW, LICSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:KATIE
Authorized Official - Middle Name:
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:509-528-9593
Mailing Address - Street 1:8350 W GRANDRIDGE BLVD STE 200
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-1678
Mailing Address - Country:US
Mailing Address - Phone:509-528-9593
Mailing Address - Fax:
Practice Address - Street 1:8350 W GRANDRIDGE BLVD STE 200
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-1678
Practice Address - Country:US
Practice Address - Phone:509-528-9593
Practice Address - Fax:509-381-7009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-05
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health