Provider Demographics
NPI:1194765024
Name:FOX, BARBARA SUSAN (LISW CP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:SUSAN
Last Name:FOX
Suffix:
Gender:F
Credentials:LISW CP
Other - Prefix:MS
Other - First Name:BARBARA
Other - Middle Name:RADIN
Other - Last Name:FOX
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LISW CP
Mailing Address - Street 1:2045 MAYBANK HWY
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29412
Mailing Address - Country:US
Mailing Address - Phone:843-795-1100
Mailing Address - Fax:843-225-4014
Practice Address - Street 1:2045 MAYBANK HWY
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29412
Practice Address - Country:US
Practice Address - Phone:843-795-1100
Practice Address - Fax:843-225-4014
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC72861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical