Healthcare Provider Details

I. General information

NPI: 1003344094
Provider Name (Legal Business Name): MAC AARRON FISH LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/02/2017
Last Update Date: 04/08/2026
Certification Date: 04/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

844 GRAND AVE UNIT B
GRAND JUNCTION CO
81501-4623
US

IV. Provider business mailing address

844 GRAND AVE UNIT B
GRAND JUNCTION CO
81501-4623
US

V. Phone/Fax

Practice location:
  • Phone: 970-697-7995
  • Fax:
Mailing address:
  • Phone: 970-697-7995
  • Fax: 833-490-1313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLPC.0015143
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: