Provider Demographics
NPI:1700549227
Name:FOX, KEVIN (LMHC)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 NOTTINGHAM DR
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-2213
Mailing Address - Country:US
Mailing Address - Phone:407-782-4034
Mailing Address - Fax:
Practice Address - Street 1:206 W SYBELIA AVE
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-4739
Practice Address - Country:US
Practice Address - Phone:407-782-4034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-21
Last Update Date:2021-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH19814101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health