Provider Demographics
NPI:1790174795
Name:FOX, DANA (LCSW)
Entity Type:Individual
Prefix:
First Name:DANA
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 1:10035 W DARTMOUTH AVE
Mailing Address - Street 2:108
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80227-5620
Mailing Address - Country:US
Mailing Address - Phone:317-430-1348
Mailing Address - Fax:
Practice Address - Street 1:10035 W DARTMOUTH AVE
Practice Address - Street 2:108
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80227-5620
Practice Address - Country:US
Practice Address - Phone:317-430-1348
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-13
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099235241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical