Healthcare Provider Details

I. General information

NPI: 1396600979
Provider Name (Legal Business Name): LAUREN FISHER
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/17/2025
Last Update Date: 12/17/2025
Certification Date: 12/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1135 KILDAIRE FARM RD STE 200
CARY NC
27511-4587
US

IV. Provider business mailing address

5810 FAULKNER ST UNIT 1303
DURHAM NC
27703-7408
US

V. Phone/Fax

Practice location:
  • Phone: 919-300-6717
  • Fax:
Mailing address:
  • Phone: 919-328-0511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023289
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: