Provider Demographics
NPI:1376208801
Name:FISCHER, ALICE (LSW)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1461 WALLINGFORD RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:19064-3965
Mailing Address - Country:US
Mailing Address - Phone:484-241-6542
Mailing Address - Fax:
Practice Address - Street 1:1461 WALLINGFORD RD
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:PA
Practice Address - Zip Code:19064-3965
Practice Address - Country:US
Practice Address - Phone:484-241-6542
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-31
Last Update Date:2021-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW134016104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker