=====================================================
General NPI Number Information
=====================================================
NPI Number | 1851008452
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JODI FOX LPC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/02/2022
-----------------------------------------------------
Last Update Date | 11/14/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1470 E MAIN ST
-----------------------------------------------------
City | ANNVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17003-1613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-473-0811
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1470 E MAIN ST
-----------------------------------------------------
City | ANNVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 17003-1613
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 717-219-8223
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YP2500X
-----------------------------------------------------
Taxonomy Name | Professional Counselor
-----------------------------------------------------
License Number | PC015013
-----------------------------------------------------
License Number State | PA
-----------------------------------------------------