Provider Demographics
NPI:1548698731
Name:FOX, KATHRINE (LPC)
Entity type:Individual
Prefix:
First Name:KATHRINE
Middle Name:
Last Name:FOX
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KATHRINE
Other - Middle Name:
Other - Last Name:SIDEBOTTOM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2612 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43065-9724
Mailing Address - Country:US
Mailing Address - Phone:740-816-7387
Mailing Address - Fax:614-453-8192
Practice Address - Street 1:2 W WINTER ST
Practice Address - Street 2:SUITE #208
Practice Address - City:DELAWARE
Practice Address - State:OH
Practice Address - Zip Code:43015-1991
Practice Address - Country:US
Practice Address - Phone:740-816-7387
Practice Address - Fax:614-453-8192
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-24
Last Update Date:2013-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.0800086101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health