Provider Demographics
NPI:1245720861
Name:FOX AND THISTLE LLC
Entity type:Organization
Organization Name:FOX AND THISTLE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:E
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:360-421-2741
Mailing Address - Street 1:19091 COOK RD
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98233-9698
Mailing Address - Country:US
Mailing Address - Phone:360-421-2741
Mailing Address - Fax:
Practice Address - Street 1:203 W HOLLY ST STE 320
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4329
Practice Address - Country:US
Practice Address - Phone:360-421-2741
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-18
Last Update Date:2018-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty