Provider Demographics
NPI:1568450864
Name:FOX, DEBRA L (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:L
Last Name:FOX
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8401 LAKE WORTH RD
Mailing Address - Street 2:SUITE 219
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-2400
Mailing Address - Country:US
Mailing Address - Phone:561-312-6622
Mailing Address - Fax:561-713-1175
Practice Address - Street 1:8401 LAKE WORTH RD
Practice Address - Street 2:SUITE 219
Practice Address - City:LAKE WORTH
Practice Address - State:FL
Practice Address - Zip Code:33467-2400
Practice Address - Country:US
Practice Address - Phone:561-312-6622
Practice Address - Fax:561-713-1175
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 80231041C0700X
NYR0331081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL052344OtherVALUE OPTIONS
NY01393737Medicaid
FLAB354OtherMEDICARE RENDERING PROVID
FL103958735OtherUNITED BEHAVIORAL HEALTH
NY7401290OtherGHI