Provider Demographics
NPI:1316099377
Name:FOX, MATTHEW L (LMHC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:L
Last Name:FOX
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3261 COMMERCIAL WAY
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34606-2694
Mailing Address - Country:US
Mailing Address - Phone:352-686-3188
Mailing Address - Fax:352-686-9394
Practice Address - Street 1:3261 COMMERCIAL WAY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34606-2694
Practice Address - Country:US
Practice Address - Phone:352-686-3188
Practice Address - Fax:352-686-9394
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH7970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health