Healthcare Provider Details

I. General information

NPI: 1720467095
Provider Name (Legal Business Name): NICOLE FISHER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2015
Last Update Date: 04/29/2026
Certification Date: 04/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1318 E CHURCHVILLE RD LOWR LEVEL
BEL AIR MD
21014-4707
US

IV. Provider business mailing address

1318 E CHURCHVILLE RD LOWR LEVEL
BEL AIR MD
21014-4707
US

V. Phone/Fax

Practice location:
  • Phone: 410-838-2493
  • Fax: 410-838-2493
Mailing address:
  • Phone: 410-838-2493
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberLC6295
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: