Healthcare Provider Details

I. General information

NPI: 1598233710
Provider Name (Legal Business Name): ABBY MARIE FISHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2018
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 S MAIN ST RM 217
ANN ARBOR MI
48104-2117
US

IV. Provider business mailing address

300 W WASHINGTON AVE STE 210B
JACKSON MI
49201-2160
US

V. Phone/Fax

Practice location:
  • Phone: 517-344-0913
  • Fax: 517-905-6007
Mailing address:
  • Phone: 517-344-0913
  • Fax: 517-905-6007

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6401226515
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number1377
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: