Healthcare Provider Details

I. General information

NPI: 1558999045
Provider Name (Legal Business Name): KERI FOX LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2020
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7671 QUARTERFIELD RD STE 301
GLEN BURNIE MD
21061-4525
US

IV. Provider business mailing address

7671 QUARTERFIELD RD STE 301
GLEN BURNIE MD
21061-4525
US

V. Phone/Fax

Practice location:
  • Phone: 410-457-3041
  • Fax: 410-210-2126
Mailing address:
  • Phone: 410-457-3041
  • Fax: 410-210-2126

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30076
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: