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NPI Code Detail

MEDICARE: TARA FISHER LCSW

MEDICARE: TARA FISHER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerCSW008192GA

General Provider Information

NPI Number : 1134605520
Entity Type Code : Individual
Provider Name (Legal Business Name) : TARA FISHER LCSW
Provider Business Mailing Address
First Line : 675 SEMINOLE AVE NE STE 310
Second Line :
City : ATLANTA
State : GA
Zip : 30307-3416
Country : US
Telephone Number : 404-890-0195
Fax Number :
Provider Business Practice Location Address
First Line : 675 SEMINOLE AVE NE STE 310
Second Line :
City : ATLANTA
State : GA
Zip : 30307-3416
Country : US
Telephone Number : 404-890-0195
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2018
Last Update Date : 06/10/2024

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Directions to “ TARA FISHER LCSW” Practice Location

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