Provider Demographics
NPI:1528777570
Name:FOX, ROGER II (LCSW)
Entity type:Individual
Prefix:
First Name:ROGER
Middle Name:
Last Name:FOX
Suffix:II
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 FOXHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-1056
Mailing Address - Country:US
Mailing Address - Phone:859-625-5235
Mailing Address - Fax:859-625-5237
Practice Address - Street 1:1621 FOXHAVEN DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:KY
Practice Address - Zip Code:40475-1056
Practice Address - Country:US
Practice Address - Phone:859-625-5235
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-18
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY2599811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY259981OtherKENTUCKY BOARD OF SOCIAL WORK
KY257483OtherKENTUCKY BOARD OF SOCIAL WORK