Healthcare Provider Details

I. General information

NPI: 1518903905
Provider Name (Legal Business Name): FISHEL, WATSON, & LEMAIRE PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 01/23/2020
Certification Date: 01/23/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E PENNSYLVANIA AVE
TOWSON MD
21286-5118
US

IV. Provider business mailing address

110 E PENNSYLVANIA AVE
TOWSON MD
21286-5118
US

V. Phone/Fax

Practice location:
  • Phone: 410-583-2222
  • Fax: 410-583-2377
Mailing address:
  • Phone: 410-583-2222
  • Fax: 410-583-2377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBERTA ROSENTHAL
Title or Position: OFFICE MANAGER
Credential:
Phone: 410-583-2222