Provider Demographics
NPI:1952799314
Name:FOX, ERIC DAVID (LCSW)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:DAVID
Last Name:FOX
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 MONMOUTH RD STE 7
Mailing Address - Street 2:
Mailing Address - City:OAKHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07755-1561
Mailing Address - Country:US
Mailing Address - Phone:732-662-8853
Mailing Address - Fax:
Practice Address - Street 1:220 MONMOUTH RD STE 7
Practice Address - Street 2:
Practice Address - City:OAKHURST
Practice Address - State:NJ
Practice Address - Zip Code:07755-1561
Practice Address - Country:US
Practice Address - Phone:732-662-8853
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-07
Last Update Date:2023-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057362001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical