MEDICARE: MRS. FATEAMA L FISHER LPCC

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	101YP2500X	Professional Counselor	E.2607049	OH

General Provider Information

NPI Number	:	1417402421
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FATEAMA L FISHER LPCC

Provider Business Mailing Address
First Line	:	3694 BEACONTREE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2503
Country	:	US
Telephone Number	:	330-506-7254
Fax Number	:

Provider Business Practice Location Address
First Line	:	3694 BEACONTREE DR
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43224-2503
Country	:	US
Telephone Number	:	330-506-7254
Fax Number	:

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

Provider Enumeration Date	:	08/19/2016
Last Update Date	:	05/08/2026

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