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General NPI Number Information
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NPI Number | 1730714940
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Entity Type | Organization
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Legal Business Name | ANDREW M. FISHER COUNSELING P.C.
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Dates
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Enumeration Date | 03/08/2020
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Last Update Date | 03/08/2020
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Provider Practice Location Address
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Address Line | 1180 N CONVENT ST
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City | BOURBONNAIS
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State | IL
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Zip | 60914-1004
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Country | US
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Telephone | 815-450-9288
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Fax |
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Provider Business Mailing Address
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Address Line | 1021 FLAMINGO LN
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City | BRADLEY
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State | IL
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Zip | 60915-1315
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Country | US
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Telephone | 815-450-9288
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANDREW M FISHER
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Credential | MA, LCPC
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Telephone | 815-450-9288
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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 |
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License Number State |
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