Provider Demographics
NPI:1629092341
Name:FOX, DEBORAH (LCSW)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:
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 1:311 NW 97TH LN
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33071-6822
Mailing Address - Country:US
Mailing Address - Phone:954-346-8409
Mailing Address - Fax:
Practice Address - Street 1:100 S PINE ISLAND RD
Practice Address - Street 2:STE 230
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33324-2613
Practice Address - Country:US
Practice Address - Phone:954-370-2140
Practice Address - Fax:954-916-1252
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW02681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLZ3335ZMedicare PIN