Provider Demographics
NPI:1083040265
Name:FISHER, KAYLA SUE (LSCSW)
Entity Type:Individual
Prefix:
First Name:KAYLA
Middle Name:SUE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1913 M ST
Mailing Address - Street 2:
Mailing Address - City:BELLEVILLE
Mailing Address - State:KS
Mailing Address - Zip Code:66935-2238
Mailing Address - Country:US
Mailing Address - Phone:785-527-8271
Mailing Address - Fax:786-527-8317
Practice Address - Street 1:710 S MERIDIAN ST
Practice Address - Street 2:
Practice Address - City:PLAINVILLE
Practice Address - State:KS
Practice Address - Zip Code:67663-3211
Practice Address - Country:US
Practice Address - Phone:785-560-3101
Practice Address - Fax:785-527-8317
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2021-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4623104100000X
KS1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker