MEDICARE: RASHIDA KARRIEM FISHER LPCC, LADC

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	101YM0800X	Mental Health Counselor	1376	MN
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	302200	MN

General Provider Information

NPI Number	:	1457541286
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RASHIDA KARRIEM FISHER LPCC, LADC

Provider Business Mailing Address
First Line	:	690 CLEVELAND AVE S
Second Line	:	SUITE 150
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1319
Country	:	US
Telephone Number	:	612-743-2155
Fax Number	:

Provider Business Practice Location Address
First Line	:	690 CLEVELAND AVE S
Second Line	:	SUITE 150
City	:	SAINT PAUL
State	:	MN
Zip	:	55116-1319
Country	:	US
Telephone Number	:	651-493-2856
Fax Number	:

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

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	12/07/2016

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