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General NPI Number Information
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NPI Number | 1831852003
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Entity Type | Individual
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Provider Name | LISA M FISHER LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/14/2021
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Last Update Date | 09/09/2023
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Provider Practice Location Address
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Address Line | 200 JUNEBERRY WAY UNIT 2A
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City | GLEN BURNIE
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State | MD
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Zip | 21061-2321
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Country | US
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Telephone | 443-286-1763
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Fax |
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Provider Business Mailing Address
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Address Line | 200 JUNEBERRY WAY UNIT 2A
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City | GLEN BURNIE
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State | MD
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Zip | 21061-2321
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Country | US
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Telephone | 443-286-1763
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LC14272
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License Number State | MD
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