MEDICARE: PAMELA L FOX LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1164433389
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PAMELA L FOX LLC

Provider Business Mailing Address
First Line	:	701 P ST
Second Line	:	STE. 305
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-420-6621
Fax Number	:

Provider Business Practice Location Address
First Line	:	701 P ST
Second Line	:	STE. 305
City	:	LINCOLN
State	:	NE
Zip	:	68508-1356
Country	:	US
Telephone Number	:	402-420-6621
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PROVIDER
Name	:	PAMELA L FOX
Credential	:	LMHP, RN
Telephone Number	:	402-420-6621

Provider Enumeration Date	:	08/11/2006
Last Update Date	:	08/22/2020

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Directions to “PAMELA L FOX LLC ” Practice Location

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