MEDICARE: MRS. SHELBY ELIZABETH FISCHER LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	8686	MA
2	101YM0800X	Mental Health Counselor	MHC00777	RI
3	103TC1900X	Counseling Psychologist	MHC00777	RI

General Provider Information

NPI Number	:	1326327289
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SHELBY ELIZABETH FISCHER LMHC

Provider Business Mailing Address
First Line	:	640 GEORGE WASHINGTON HWY
Second Line	:	BLDG B. SUITE 103
City	:	LINCOLN
State	:	RI
Zip	:	02865-4716
Country	:	US
Telephone Number	:	401-405-1229
Fax Number	:	401-466-7970

Provider Business Practice Location Address
First Line	:	640 GEORGE WASHINGTON HWY
Second Line	:	BUILDING B. SUITE 103
City	:	LINCOLN
State	:	RI
Zip	:	02865-4716
Country	:	US
Telephone Number	:	401-405-1229
Fax Number	:	401-466-7970

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/10/2011
Last Update Date	:	08/31/2018

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