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General NPI Number Information
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NPI Number | 1457720435
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Entity Type | Organization
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Legal Business Name | AMY FISCHER
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 1506 SAVILE LN
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City | WASHINGTON
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State | IL
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Zip | 61571-4611
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Country | US
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Telephone | 309-532-8455
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Fax |
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Provider Business Mailing Address
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Address Line | 1506 SAVILE LN
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City | WASHINGTON
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State | IL
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Zip | 61571-4611
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Country | US
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Telephone | 309-532-8455
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Fax |
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Authorized Official
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Title or Position | LCSW/OWNER
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Name | AMY MICHELLE FISCHER
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Credential | LCSW
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Telephone | 309-532-8455
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 149015544
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149015544
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License Number State | IL
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