Provider Demographics
NPI:1689813081
Name:FOX, NANCY (LISW-CP)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 STREATER LN
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29625-6225
Mailing Address - Country:US
Mailing Address - Phone:864-367-5688
Mailing Address - Fax:864-314-8527
Practice Address - Street 1:4120 CLEMSON BLVD STE G
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621-1176
Practice Address - Country:US
Practice Address - Phone:864-367-5688
Practice Address - Fax:864-314-8527
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-10
Last Update Date:2009-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC72941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical