Provider Demographics
NPI:1548316995
Name:FOX, PAMELA LORRAINE (PHD, LCSW-S)
Entity type:Individual
Prefix:DR
First Name:PAMELA
Middle Name:LORRAINE
Last Name:FOX
Suffix:
Gender:F
Credentials:PHD, LCSW-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:2208 HORNED OWL STREET
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-1956
Mailing Address - Country:US
Mailing Address - Phone:469-236-5132
Mailing Address - Fax:972-623-1050
Practice Address - Street 1:3901 ARLINGTON HIGHLANDS BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-6001
Practice Address - Country:US
Practice Address - Phone:469-236-5132
Practice Address - Fax:972-623-1050
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-26
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TX50138104100000X, 106H00000X, 1041C0700X, 101YA0400X, 101YM0800X, 101YP1600X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional