Provider Demographics
NPI:1922394584
Name:FOX, GERALDINE A (LCSW-C, LICSW)
Entity type:Individual
Prefix:
First Name:GERALDINE
Middle Name:A
Last Name:FOX
Suffix:
Gender:F
Credentials:LCSW-C, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:158 N WHAT A VIEW LANE
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726
Mailing Address - Country:US
Mailing Address - Phone:304-209-8609
Mailing Address - Fax:
Practice Address - Street 1:158 N WHAT A VIEW LANE
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726
Practice Address - Country:US
Practice Address - Phone:304-209-8609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD195121041C0700X
OHI11000561041C0700X
WVDP009439351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical