Provider Demographics
NPI:1194740142
Name:FOX, JOY ANN (M ED, LPC)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:ANN
Last Name:FOX
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5096
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75608-5096
Mailing Address - Country:US
Mailing Address - Phone:903-236-8505
Mailing Address - Fax:903-236-8510
Practice Address - Street 1:1405 COLONY CIR
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75604-4453
Practice Address - Country:US
Practice Address - Phone:903-236-8505
Practice Address - Fax:903-236-8510
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13847101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3459LCOtherBLUE CROSS BLUE SHIELD ID