Healthcare Provider Details

I. General information

NPI: 1215451711
Provider Name (Legal Business Name): TERRI MICHELE FOX LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2017
Last Update Date: 08/20/2021
Certification Date: 08/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8133 ELLIOTT ROAD, SUITE 236-B
EASTON MD
21601-1834
US

IV. Provider business mailing address

28358 CONGRESSIONAL COURT
EASTON MD
21601-8332
US

V. Phone/Fax

Practice location:
  • Phone: 410-600-3456
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLC9201
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLGP7502
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: