Provider Demographics
NPI:1548276686
Name:FOX, JOAN E (MA, LCPC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:E
Last Name:FOX
Suffix:
Gender:F
Credentials:MA, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5544 CLARENDON HILLS RD
Mailing Address - Street 2:
Mailing Address - City:CLARENDON HILLS
Mailing Address - State:IL
Mailing Address - Zip Code:60514-1534
Mailing Address - Country:US
Mailing Address - Phone:630-654-4539
Mailing Address - Fax:
Practice Address - Street 1:5544 CLARENDON HILLS RD
Practice Address - Street 2:
Practice Address - City:CLARENDON HILLS
Practice Address - State:IL
Practice Address - Zip Code:60514-1534
Practice Address - Country:US
Practice Address - Phone:630-654-4539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional