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NPI Code Detail

MEDICARE: MS. LISA MARLENE FOX L.C.S.W.

MEDICARE:  MS. LISA MARLENE FOX  L.C.S.W.
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
1101YM0800XMental Health CounselorSC00130400NJ

General Provider Information

NPI Number : 1740587443
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LISA MARLENE FOX L.C.S.W.
Provider Business Mailing Address
First Line : 221 LAUREL RD STE 105
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-8301
Country : US
Telephone Number : 856-354-0664
Fax Number :
Provider Business Practice Location Address
First Line : 221 LAUREL RD STE 105
Second Line :
City : VOORHEES
State : NJ
Zip : 08043-8301
Country : US
Telephone Number : 856-354-0664
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2011
Last Update Date : 08/13/2019

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Directions to “ MS. LISA MARLENE FOX L.C.S.W.” Practice Location

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