Healthcare Provider Details

I. General information

NPI: 1578144010
Provider Name (Legal Business Name): SHANNON FISCHER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2021
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

439 S KIRKWOOD RD STE 208
KIRKWOOD MO
63122-6100
US

IV. Provider business mailing address

439 S KIRKWOOD RD STE 208
KIRKWOOD MO
63122-6100
US

V. Phone/Fax

Practice location:
  • Phone: 314-228-8250
  • Fax:
Mailing address:
  • Phone: 314-228-8250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: