Provider Demographics
NPI:1265022057
Name:FISHER, LEIGH ANN (LMSW)
Entity Type:Individual
Prefix:
First Name:LEIGH
Middle Name:ANN
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3812 VINYARD CT NE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5224
Mailing Address - Country:US
Mailing Address - Phone:404-754-8918
Mailing Address - Fax:
Practice Address - Street 1:3812 VINYARD CT NE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5224
Practice Address - Country:US
Practice Address - Phone:404-754-8918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009485104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker