Healthcare Provider Details

I. General information

NPI: 1942940325
Provider Name (Legal Business Name): ELIZABETH MARIE FOX LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3419 TREESMILL CIR
MANHATTAN KS
66503-2191
US

IV. Provider business mailing address

3419 TREESMILL CIR
MANHATTAN KS
66503-2191
US

V. Phone/Fax

Practice location:
  • Phone: 913-963-7440
  • Fax:
Mailing address:
  • Phone: 913-963-7440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number6384
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: