MEDICARE: ALLIE FANCHER

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	LPC05718	AL

General Provider Information

NPI Number	:	1861063414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALLIE FANCHER

Provider Business Mailing Address
First Line	:	4371 NARROW LANE RD STE 201
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2975
Country	:	US
Telephone Number	:	334-747-7756
Fax Number	:	334-747-7760

Provider Business Practice Location Address
First Line	:	4371 NARROW LANE RD STE 201
Second Line	:
City	:	MONTGOMERY
State	:	AL
Zip	:	36116-2975
Country	:	US
Telephone Number	:	334-747-7756
Fax Number	:	334-747-7760

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

Provider Enumeration Date	:	07/06/2021
Last Update Date	:	01/27/2026

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Directions to “ ALLIE FANCHER ” Practice Location

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