| Ellen J Shabshai Fox Lisw Inc | |
|
2400 Calle Amelia Santa Fe NM 87505-6280 | |
| (505) 699-4312 | |
| Not Available |
| Full Name | Ellen J Shabshai Fox Lisw Inc |
|---|---|
| Speciality | Social Worker |
| Location | 2400 Calle Amelia, Santa Fe, New Mexico |
| Authorized Official Name and Position | Ellen Fox (OWNER) |
| Authorized Official Contact | 5056994312 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ellen J Shabshai Fox Lisw Inc 2400 Calle Amelia Santa Fe NM 87505-6280 Ph: () - | Ellen J Shabshai Fox Lisw Inc 2400 Calle Amelia Santa Fe NM 87505-6280 Ph: (505) 699-4312 |
| NPI Number | 1790357887 |
|---|---|
| Provider Enumeration Date | 07/16/2021 |
| Last Update Date | 07/16/2021 |
| Certification Date | 06/21/2021 |
| Medicare PECOS PAC ID | 8224432729 |
|---|---|
| Medicare Enrollment ID | O20210805001493 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1790357887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Ellen J Fox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1932226057 PECOS PAC ID: 9133523632 Enrollment ID: I20210809001127 |
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