Provider Demographics
NPI:1942289327
Name:FOX, MEREDITH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEREDITH
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 1:307 LAFAYETTE BLVD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22401-6066
Mailing Address - Country:US
Mailing Address - Phone:540-656-2122
Mailing Address - Fax:540-656-2140
Practice Address - Street 1:307 LAFAYETTE BLVD
Practice Address - Street 2:SUITE 300
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22401-6066
Practice Address - Country:US
Practice Address - Phone:540-656-2122
Practice Address - Fax:540-656-2140
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-12
Last Update Date:2017-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-031017-11041C0700X
VA09040073771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY010031017OtherBC/BS PROVIDER ID
NY740-3598OtherGHI PROVIDER ID
NY01406679Medicaid
NY103295FKOtherPREF CARE PROVIDER ID
NY800012686OtherRAILROAD MEDICARE PR ID #
NY5987487OtherAETNA PROVIDER ID
NY10948BMedicare ID - Type UnspecifiedPROVIDER ID #