Provider Demographics
NPI:1770904849
Name:OLD FOX COUNSELING, LLC
Entity type:Organization
Organization Name:OLD FOX COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:ARLENE
Authorized Official - Middle Name:LOUISE
Authorized Official - Last Name:BUTLER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:1540-683-1392
Mailing Address - Street 1:1216 GRANNY SMITH RD
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:VA
Mailing Address - Zip Code:22642-6033
Mailing Address - Country:US
Mailing Address - Phone:540-683-1392
Mailing Address - Fax:
Practice Address - Street 1:106 CHESTER ST STE 8
Practice Address - Street 2:
Practice Address - City:FRONT ROYAL
Practice Address - State:VA
Practice Address - Zip Code:22630-3323
Practice Address - Country:US
Practice Address - Phone:540-683-1392
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-17
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0904007186261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)