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General NPI Number Information
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NPI Number | 1962599613
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Entity Type | Individual
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Provider Name | MONICA FISCHBACH LCPC
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Gender | Female
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 04/17/2020
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Provider Practice Location Address
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Address Line | 333 LINCOLN ST STE 220
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City | SACO
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State | ME
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Zip | 04072-3113
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Country | US
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Telephone | 207-415-5094
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Fax | 207-282-8030
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Provider Business Mailing Address
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Address Line | 44 YARMOUTH RD
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City | GRAY
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State | ME
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Zip | 04039-9601
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Country | US
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Telephone | 207-415-5094
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Fax | 207-282-8030
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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 | CC2296
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License Number State | ME
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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 | CC2296
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License Number State | ME
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