MEDICARE: MS. CARMELA H FISHER LCPC

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	LC3531	MD

General Provider Information

NPI Number	:	1780993279
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CARMELA H FISHER LCPC

Provider Business Mailing Address
First Line	:	10821 RED RUN BLVD UNIT 353
Second Line	:
City	:	OWINGS MILLS
State	:	MD
Zip	:	21117-8527
Country	:	US
Telephone Number	:	410-319-6346
Fax Number	:

Provider Business Practice Location Address
First Line	:	5457 TWIN KNOLLS RD STE 300
Second Line	:
City	:	COLUMBIA
State	:	MD
Zip	:	21045-3296
Country	:	US
Telephone Number	:	410-656-9146
Fax Number	:

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

Provider Enumeration Date	:	09/30/2010
Last Update Date	:	09/23/2022

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