Provider Demographics
NPI:1326327289
Name:FISCHER, SHELBY ELIZABETH (LMHC)
Entity Type:Individual
Prefix:MRS
First Name:SHELBY
Middle Name:ELIZABETH
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:640 GEORGE WASHINGTON HWY
Mailing Address - Street 2:BLDG B. SUITE 103
Mailing Address - City:LINCOLN
Mailing Address - State:RI
Mailing Address - Zip Code:02865-4716
Mailing Address - Country:US
Mailing Address - Phone:401-405-1229
Mailing Address - Fax:401-466-7970
Practice Address - Street 1:640 GEORGE WASHINGTON HWY
Practice Address - Street 2:BUILDING B. SUITE 103
Practice Address - City:LINCOLN
Practice Address - State:RI
Practice Address - Zip Code:02865-4716
Practice Address - Country:US
Practice Address - Phone:401-405-1229
Practice Address - Fax:401-466-7970
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-10
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8686101YM0800X
RIMHC00777101YM0800X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health