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General NPI Number Information
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NPI Number | 1831481944
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Entity Type | Individual
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Provider Name | NATASHA E. WALTER-FISK LPCC, LMFT, LPC
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Gender | Female
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Dates
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Enumeration Date | 05/07/2011
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Last Update Date | 10/06/2023
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Provider Practice Location Address
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Address Line | 631 19TH AVE
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City | SAN FRANCISCO
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State | CA
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Zip | 94121-3829
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Country | US
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Telephone | 415-806-7977
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Fax |
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Provider Business Mailing Address
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Address Line | 3707 GRAND WAY APT 313
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City | ST LOUIS PARK
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State | MN
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Zip | 55416-2754
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Country | US
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Telephone | 415-806-7977
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | LMFT.47582
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC.0005742
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPCC.2624
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License Number State | MN
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