Provider Demographics
NPI:1285972794
Name:FOX, TAMMY (LCPC)
Entity type:Individual
Prefix:MRS
First Name:TAMMY
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E OGDEN AVE STE 130
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3664
Mailing Address - Country:US
Mailing Address - Phone:630-995-9905
Mailing Address - Fax:630-995-9905
Practice Address - Street 1:201 E OGDEN AVE STE 130
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3664
Practice Address - Country:US
Practice Address - Phone:630-995-9905
Practice Address - Fax:630-995-9905
Is Sole Proprietor?:No
Enumeration Date:2013-01-18
Last Update Date:2013-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008421101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health