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NPI Code Detail

MEDICARE: KELLY FISCHER LMHC

MEDICARE: KELLY FISCHER LMHC
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
1101YM0800XMental Health Counselor097264IA

General Provider Information

NPI Number : 1538790530
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLY FISCHER LMHC
Provider Business Mailing Address
First Line : 3301 CEDAR HEIGHTS DR
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-6041
Country : US
Telephone Number : 319-318-1205
Fax Number :
Provider Business Practice Location Address
First Line : 3301 CEDAR HEIGHTS DR
Second Line :
City : CEDAR FALLS
State : IA
Zip : 50613-6041
Country : US
Telephone Number : 319-318-1205
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/28/2020
Last Update Date : 11/14/2024

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