Healthcare Provider Details

I. General information

NPI: 1639098767
Provider Name (Legal Business Name): JAIME FAYE FOX LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FAYE FOX LCSWA

II. Dates (important events)

Enumeration Date: 07/13/2026
Last Update Date: 07/13/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6815 POPE STREET
FALCON NC
28342
US

IV. Provider business mailing address

PO BOX 163
FALCON NC
28342-0163
US

V. Phone/Fax

Practice location:
  • Phone: 910-585-4381
  • Fax:
Mailing address:
  • Phone: 910-585-4381
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023773
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: