Healthcare Provider Details

I. General information

NPI: 1316099377
Provider Name (Legal Business Name): MATTHEW L FOX LMHC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 PINELLAS ST STE 325
CLEARWATER FL
33756-3320
US

IV. Provider business mailing address

2995 DREW ST FL 2
CLEARWATER FL
33759-3012
US

V. Phone/Fax

Practice location:
  • Phone: 727-298-6121
  • Fax: 727-533-5903
Mailing address:
  • Phone: 727-532-0002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH7970
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: