Provider Demographics
NPI:1003362773
Name:FISCHER, MARTHA F (LMFT)
Entity Type:Individual
Prefix:
First Name:MARTHA
Middle Name:F
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10712 CROSS SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:RESTON
Mailing Address - State:VA
Mailing Address - Zip Code:20191-5106
Mailing Address - Country:US
Mailing Address - Phone:703-867-8135
Mailing Address - Fax:703-867-8135
Practice Address - Street 1:425 CARLISLE DR STE A
Practice Address - Street 2:
Practice Address - City:HERNDON
Practice Address - State:VA
Practice Address - Zip Code:20170-5618
Practice Address - Country:US
Practice Address - Phone:703-867-8135
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0717001395106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist