Provider Demographics
NPI:1881241842
Name:MEGHAN L. FOX, PSY.D., P.L.L.C.
Entity type:Organization
Organization Name:MEGHAN L. FOX, PSY.D., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGHAN
Authorized Official - Middle Name:LEAH
Authorized Official - Last Name:FOX
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:585-633-8758
Mailing Address - Street 1:1580 ELMWOOD AVE STE D
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-3620
Mailing Address - Country:US
Mailing Address - Phone:585-633-8758
Mailing Address - Fax:
Practice Address - Street 1:1580 ELMWOOD AVE STE D
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-3620
Practice Address - Country:US
Practice Address - Phone:585-633-8758
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2019-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY05445827Medicaid