=====================================================
General NPI Number Information
=====================================================
NPI Number | 1639098767
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JAIME FAYE FOX LCSWA
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/13/2026
-----------------------------------------------------
Last Update Date | 07/13/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6815 POPE STREET
-----------------------------------------------------
City | FALCON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28342
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-585-4381
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 163
-----------------------------------------------------
City | FALCON
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28342-0163
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-585-4381
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | P023773
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------