Healthcare Provider Details

I. General information

NPI: 1538556659
Provider Name (Legal Business Name): CHRYSTAL FOX-MCCORMICK LMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2015
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2505 NORTH RD
ORISKANY FALLS NY
13425-4437
US

IV. Provider business mailing address

2505 NORTH RD
ORISKANY FALLS NY
13425-4437
US

V. Phone/Fax

Practice location:
  • Phone: 315-813-8032
  • Fax:
Mailing address:
  • Phone: 315-813-8032
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number002848
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: