Individual provider Active NPI

Holly Fox

  • Mental Health Counselor
  • Fairbanks, AK
National Provider Identifier
1053550871
Registry record updated Feb 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
3830 S Cushman St
Fairbanks, AK 99701-7530
Phone
(907) 455-1572
Fax
(907) 455-5255
NPI assigned
Feb 18, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 18, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

3830 S Cushman St
Fairbanks, AK 99701-7530

Mailing address

3830 S Cushman St
Fairbanks, AK 99701-7530
Phone (907) 455-1572

Other identifiers 1

IdentifierTypeStateIssuer
MH0157MedicaidAK

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1234915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1234915200000",
    "number": "1053550871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3830 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017530",
            "telephone_number": "907-455-1572",
            "fax_number": "907-455-5255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3830 S CUSHMAN ST",
            "city": "FAIRBANKS",
            "state": "AK",
            "postal_code": "997017530",
            "telephone_number": "907-455-1572",
            "fax_number": "907-455-5255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "HOLLY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-02-18",
        "last_updated": "2009-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "MH0157",
            "state": "AK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairbanks, AK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.