Roman Chance Fox, RECREATION THERAPIST

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH27960 Issued in FL

Practice address

17502 Fallowfield Dr
Lutz, FL 33549-5584

Phone

(757) 333-1112

NPI assigned

Dec 9, 2016

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1481241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1396289328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16727 CARACARA CT",
            "city": "SPRING HILL",
            "state": "FL",
            "postal_code": "346109011",
            "telephone_number": "757-333-1112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17502 FALLOWFIELD DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335495584",
            "telephone_number": "757-333-1112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOX",
        "first_name": "ROMAN",
        "middle_name": "CHANCE",
        "name_prefix": "Mr.",
        "credential": "RECREATION THERAPIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-12-09",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "FL",
            "license": "PTA 26297",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH27960",
            "primary": true
        },
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maliah Ariel Fortes
• Tyler Fortwangler
• Steven Mark Fountain, ARNP
• Fourth Trimester Wellness LLC
• Emily Marie Fowler, MS, CCC-SLP
• Katarzyna Frackowiak
• John Temple Fraker, M.D.
• Deewye Villanueva Franklin, MS CCC-SLP
• Rachel Lee Franz, DMD
• Keri L Freeman

• Mental Health Counselor in Lutz, FL
• Providers in Lutz, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2026; 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.