MEDICARE: CALEB FISHER LMSW

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
1	104100000X	Social Worker	2025005693	MO

General Provider Information

NPI Number	:	1447059647
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALEB FISHER LMSW

Provider Business Mailing Address
First Line	:	1736 E SUNSHINE ST STE 811
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65804-1334
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	440 S MARKET AVE
Second Line	:
City	:	SPRINGFIELD
State	:	MO
Zip	:	65806-2026
Country	:	US
Telephone Number	:	417-221-4854
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2025
Last Update Date	:	05/05/2025

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