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General NPI Number Information
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NPI Number | 1376857680
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Entity Type | Individual
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Provider Name | KIMBERLY SPAHR FISHER LCPC
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Gender | Female
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Dates
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Enumeration Date | 07/28/2010
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Last Update Date | 07/28/2010
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Provider Practice Location Address
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Address Line | 990 GROVE ST SUIE 409
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City | EVANSTON
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State | IL
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Zip | 60201-6510
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Country | US
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Telephone | 773-318-7462
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Fax |
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Provider Business Mailing Address
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Address Line | 221 S ALBERT ST
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City | MOUNT PROSPECT
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State | IL
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Zip | 60056-3405
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Country | US
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Telephone | 773-318-7462
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180.005396
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License Number State | IL
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