MEDICARE: LAURA FLEISCHER, LMHC, LLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1306163050	OTHER	MA	NPI

General Provider Information

NPI Number	:	1578151353
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAURA FLEISCHER, LMHC, LLC

Provider Business Mailing Address
First Line	:	35 COTTAGE ST
Second Line	:
City	:	SHARON
State	:	MA
Zip	:	02067-2130
Country	:	US
Telephone Number	:	914-924-0557
Fax Number	:	339-230-3211

Provider Business Practice Location Address
First Line	:	742 WASHINGTON ST
Second Line	:
City	:	CANTON
State	:	MA
Zip	:	02021-3039
Country	:	US
Telephone Number	:	914-924-0557
Fax Number	:	339-230-3211

Authorized Official
Title or Position	:	OWNER
Name	:	LAURA FLEISCHER
Credential	:	LMHC
Telephone Number	:	914-924-0557

Provider Enumeration Date	:	01/06/2021
Last Update Date	:	01/06/2021

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