Provider Demographics
NPI:1407183890
Name:THOMPSON-FISHER, BRANDY LACHELLE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:BRANDY
Middle Name:LACHELLE
Last Name:THOMPSON-FISHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 VALLEY HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSPORT
Mailing Address - State:PA
Mailing Address - Zip Code:17701-1924
Mailing Address - Country:US
Mailing Address - Phone:570-651-9087
Mailing Address - Fax:
Practice Address - Street 1:123 VALLEY HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:WILLIAMSPORT
Practice Address - State:PA
Practice Address - Zip Code:17701-1924
Practice Address - Country:US
Practice Address - Phone:570-651-9087
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-06
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0163931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical