Provider Demographics
NPI:1407498231
Name:FISHER, HALEIGH MICHELLE (LPC)
Entity Type:Individual
Prefix:
First Name:HALEIGH
Middle Name:MICHELLE
Last Name:FISHER
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 1:2016 NATCHEZ AVE
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:TX
Mailing Address - Zip Code:76022-7644
Mailing Address - Country:US
Mailing Address - Phone:940-368-3409
Mailing Address - Fax:
Practice Address - Street 1:1000 S MAIN ST STE 200
Practice Address - Street 2:
Practice Address - City:GRAPEVINE
Practice Address - State:TX
Practice Address - Zip Code:76051-7503
Practice Address - Country:US
Practice Address - Phone:940-368-3409
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-14
Last Update Date:2019-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX78929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health