Provider Demographics
NPI:1841747797
Name:FOX, NINA J (LMSW)
Entity Type:Individual
Prefix:
First Name:NINA
Middle Name:J
Last Name:FOX
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8350 E RAINTREE DR
Mailing Address - Street 2:STE 130
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85260-2692
Mailing Address - Country:US
Mailing Address - Phone:602-338-9699
Mailing Address - Fax:561-282-3238
Practice Address - Street 1:10799 N 90TH ST STE 100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260-6110
Practice Address - Country:US
Practice Address - Phone:480-804-0326
Practice Address - Fax:480-284-5330
Is Sole Proprietor?:No
Enumeration Date:2016-09-08
Last Update Date:2021-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-13917104100000X
AZLCSW-182131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker