MEDICARE: MR. ROBERT FOX LMHC, LADC I, CEAP

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	2135	MA
2	101YM0800X	Mental Health Counselor	5333	MA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	LM1123	OTHER	MA	BLUE CROSS-BLUE SHIELD ID
2	2135	OTHER	MA	LICENSED ALCOHOL AND DRUG
3	5333	OTHER	MA	LMHC LICENSE NUMBER

General Provider Information

NPI Number	:	1336294610
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT FOX LMHC, LADC I, CEAP

Provider Business Mailing Address
First Line	:	10 MALL RD STE 301
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-4131
Country	:	US
Telephone Number	:	781-933-0200
Fax Number	:	781-933-0301

Provider Business Practice Location Address
First Line	:	10 MALL RD STE 301
Second Line	:
City	:	BURLINGTON
State	:	MA
Zip	:	01803-4131
Country	:	US
Telephone Number	:	781-933-0200
Fax Number	:	781-933-0301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2007
Last Update Date	:	09/11/2023

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