Provider Demographics
NPI:1457507675
Name:FISHER, MICHELLE DENISE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:DENISE
Last Name:FISHER
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 1:272 JOHNNY CAKE LN
Mailing Address - Street 2:
Mailing Address - City:COXSACKIE
Mailing Address - State:NY
Mailing Address - Zip Code:12051-3217
Mailing Address - Country:US
Mailing Address - Phone:518-303-5674
Mailing Address - Fax:
Practice Address - Street 1:272 JOHNNY CAKE LN
Practice Address - Street 2:
Practice Address - City:COXSACKIE
Practice Address - State:NY
Practice Address - Zip Code:12051-3217
Practice Address - Country:US
Practice Address - Phone:518-303-5674
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-08
Last Update Date:2023-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003958101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health