Provider Demographics
NPI:1164923405
Name:FISH, LEAH KATHRYN (LPC)
Entity Type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:KATHRYN
Last Name:FISH
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 S ASH ST; PO BOX 185
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:KS
Mailing Address - Zip Code:67063-0185
Mailing Address - Country:US
Mailing Address - Phone:620-947-3200
Mailing Address - Fax:620-947-3845
Practice Address - Street 1:508 S ASH ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:KS
Practice Address - Zip Code:67063-0185
Practice Address - Country:US
Practice Address - Phone:620-947-3200
Practice Address - Fax:620-947-3845
Is Sole Proprietor?:No
Enumeration Date:2018-02-22
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
KS3226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health