Healthcare Provider Details

I. General information

NPI: 1508782830
Provider Name (Legal Business Name): CAMILLE CANTY-FISCHER LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 FREEMAN RD
CENTRAL POINT OR
97502-2740
US

IV. Provider business mailing address

1120 FREEMAN RD
CENTRAL POINT OR
97502-2740
US

V. Phone/Fax

Practice location:
  • Phone: 541-727-2578
  • Fax:
Mailing address:
  • Phone: 541-727-2578
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: CAMILLE CANTY FISCHER
Title or Position: OWNER
Credential: LCSW
Phone: 541-500-8655