Healthcare Provider Details

I. General information

NPI: 1700382900
Provider Name (Legal Business Name): KARIN FRANCES FISCALETTI LMHP, CPC, PLADC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/05/2018
Last Update Date: 05/01/2024
Certification Date: 05/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

952 CAROTHERS RD
PULLMAN WA
99163-9681
US

IV. Provider business mailing address

952 CAROTHERS RD
PULLMAN WA
99163-9681
US

V. Phone/Fax

Practice location:
  • Phone: 402-870-1861
  • Fax:
Mailing address:
  • Phone: 402-870-1861
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLCPC-8345
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLMHP-5461
License Number StateNE
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61151286
License Number StateWA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: