Provider Demographics
NPI:1588217962
Name:FOX, PAMELA RAE (LPC)
Entity type:Individual
Prefix:
First Name:PAMELA
Middle Name:RAE
Last Name:FOX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:RAE
Other - Last Name:MURRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:801 S. WOODLAWN AVE STE 15
Mailing Address - Street 2:
Mailing Address - City:O FALLON
Mailing Address - State:MO
Mailing Address - Zip Code:63366-7647
Mailing Address - Country:US
Mailing Address - Phone:636-379-1779
Mailing Address - Fax:636-634-3496
Practice Address - Street 1:801 S. WOODLAWN AVE STE 15
Practice Address - Street 2:
Practice Address - City:O FALLON
Practice Address - State:MO
Practice Address - Zip Code:63366-7647
Practice Address - Country:US
Practice Address - Phone:636-379-1779
Practice Address - Fax:636-634-3496
Is Sole Proprietor?:No
Enumeration Date:2019-07-24
Last Update Date:2022-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002020625101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health