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NPI Code Detail

MEDICARE: BETTY J FISHER LCSW

MEDICARE: BETTY J FISHER LCSW
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
11041C0700XClinical Social WorkerLSW0000003925TN

General Provider Information

NPI Number : 1891754024
Entity Type Code : Individual
Provider Name (Legal Business Name) : BETTY J FISHER LCSW
Provider Business Mailing Address
First Line : PO BOX 905
Second Line :
City : ATHENS
State : TN
Zip : 37371-0905
Country : US
Telephone Number : 423-744-8734
Fax Number : 423-649-2794
Provider Business Practice Location Address
First Line : 584 CONGRESS PKWY S
Second Line :
City : ATHENS
State : TN
Zip : 37303-2258
Country : US
Telephone Number : 423-744-8734
Fax Number : 423-649-2794
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/17/2006
Last Update Date : 11/03/2016

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