Provider Demographics
NPI:1962949255
Name:FOX, BRANDEN (MSW LISW)
Entity type:Individual
Prefix:
First Name:BRANDEN
Middle Name:
Last Name:FOX
Suffix:
Gender:M
Credentials:MSW LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2397 N TOUSSAINT PORTAGE RD
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:OH
Mailing Address - Zip Code:43449-9567
Mailing Address - Country:US
Mailing Address - Phone:419-340-1669
Mailing Address - Fax:
Practice Address - Street 1:2737 NAVARRE AVE STE 205
Practice Address - Street 2:
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3276
Practice Address - Country:US
Practice Address - Phone:419-691-8500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHS.2107095104100000X
OHI.2406081104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker