Healthcare Provider Details

I. General information

NPI: 1134137904
Provider Name (Legal Business Name): ELIZABETH MICHELLE FIZER LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 03/24/2025
Certification Date: 03/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 KENTON DR
CHARLESTON WV
25311-1256
US

IV. Provider business mailing address

10 STONY POINT RD
CHARLESTON WV
25314-1670
US

V. Phone/Fax

Practice location:
  • Phone: 304-513-3495
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number1222
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number1222
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: