MEDICARE: HEIDI FOX LISW-CP

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	1041C0700X	Clinical Social Worker	12631	SC

General Provider Information

NPI Number	:	1790627560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEIDI FOX LISW-CP

Provider Business Mailing Address
First Line	:	32 BLYTHEWOOD DR
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29607-1202
Country	:	US
Telephone Number	:	415-613-9529
Fax Number	:

Provider Business Practice Location Address
First Line	:	4006 E NORTH ST
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-2347
Country	:	US
Telephone Number	:	864-214-5742
Fax Number	:

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

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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Directions to “ HEIDI FOX LISW-CP” Practice Location

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