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General NPI Number Information
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NPI Number | 1588352454
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Entity Type | Individual
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Provider Name | ANGELA MAE FISHER LCMHCA
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Gender | Female
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Dates
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Enumeration Date | 04/27/2023
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Last Update Date | 04/27/2023
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Provider Practice Location Address
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Address Line | 10430 PARK RD STE 200
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City | CHARLOTTE
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State | NC
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Zip | 28210-8541
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Country | US
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Telephone | 704-900-0426
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Fax |
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Provider Business Mailing Address
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Address Line | 3618 ESSEX POINTE DR
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City | MONROE
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State | NC
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Zip | 28110-7714
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Country | US
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Telephone | 704-258-1413
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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 | A18682
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License Number State | NC
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