=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891416434
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LISA LYNN FISHER LMHC
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/12/2022
-----------------------------------------------------
Last Update Date | 12/12/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4156 130TH ST
-----------------------------------------------------
City | IMOGENE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51645-6038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 712-216-2003
-----------------------------------------------------
Fax | 833-478-1503
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4156 130TH ST
-----------------------------------------------------
City | IMOGENE
-----------------------------------------------------
State | IA
-----------------------------------------------------
Zip | 51645-6038
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 712-216-2003
-----------------------------------------------------
Fax | 833-478-1503
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------