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NPI 1598650814

NPI 1598650814 : FOX PSYCHOTHERAPY AND CONSULTATION, LLC : MADISON, WI

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General NPI Number Information
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    NPI Number           |    1598650814
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    Entity Type          |    Organization 
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    Legal Business Name  |    FOX PSYCHOTHERAPY AND CONSULTATION, LLC 
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Dates
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    Enumeration Date     |    06/09/2025
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    Last Update Date     |    06/09/2025
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Provider Practice Location Address
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    Address Line         |    702 N BLACKHAWK AVE STE 100 
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    City                 |    MADISON
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    State                |    WI
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    Zip                  |    53705-3357
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    Country              |    US
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    Telephone            |    608-291-3393
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    2787 FRISEE DR APT 2 
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    City                 |    FITCHBURG
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    State                |    WI
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    Zip                  |    53711-8506
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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Authorized Official
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    Title or Position    |    OWNER
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    Name                 |     TRAVIS  FOX 
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    Credential           |    PSYD
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    Telephone            |    608-291-3393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    101YM0800X
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    Taxonomy Name        |    Mental Health Counselor
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    License Number       |    
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    License Number State |    
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