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General NPI Number Information
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NPI Number | 1699165795
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Entity Type | Individual
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Provider Name | LAUREN FISCHER
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Gender | Female
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Dates
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Enumeration Date | 01/27/2015
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Last Update Date | 07/20/2021
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Provider Practice Location Address
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Address Line | 1224 ADAMS ST
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-1317
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Country | US
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Telephone | 224-795-9525
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 51302
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City | ELEELE
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State | HI
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Zip | 96705-1302
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Country | US
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Telephone | 808-431-1150
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC-761
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License Number State | HI
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