Provider Demographics
NPI:1316116056
Name:FOX, REBECCA (MA, LPC-S)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:MA, LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 I-35 S
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76706-3710
Mailing Address - Country:US
Mailing Address - Phone:254-714-0189
Mailing Address - Fax:
Practice Address - Street 1:3925 I-35 S
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76706-3710
Practice Address - Country:US
Practice Address - Phone:254-714-0189
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2008-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20025101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor