Healthcare Provider Details

I. General information

NPI: 1689354821
Provider Name (Legal Business Name): CHRISTOPHER FISHER
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2023
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 W SOUTH BOULDER RD
LAFAYETTE CO
80026-8951
US

IV. Provider business mailing address

1120 W SOUTH BOULDER RD STE 101B
LAFAYETTE CO
80026-8952
US

V. Phone/Fax

Practice location:
  • Phone: 720-897-0431
  • Fax:
Mailing address:
  • Phone: 720-897-0431
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLPCC.0024951
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: