MEDICARE: FISHER LCSW PLLC

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1780448555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FISHER LCSW PLLC

Provider Business Mailing Address
First Line	:	2 LOCARNO DR
Second Line	:
City	:	LAKE LUZERNE
State	:	NY
Zip	:	12846-3239
Country	:	US
Telephone Number	:	518-831-5238
Fax Number	:	518-379-0609

Provider Business Practice Location Address
First Line	:	2 LOCARNO DR
Second Line	:
City	:	LAKE LUZERNE
State	:	NY
Zip	:	12846-3239
Country	:	US
Telephone Number	:	518-831-5238
Fax Number	:	518-379-0609

Authorized Official
Title or Position	:	OWNER/SINGLE MEMBER
Name	:	JULIE FISHER
Credential	:	LCSWR
Telephone Number	:	518-396-7837

Provider Enumeration Date	:	02/12/2024
Last Update Date	:	07/22/2025

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