Provider Demographics
NPI:1477275691
Name:FISHER, ALEXANDRA (CSAC, ADCR)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:CSAC, ADCR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 JEFFERY AVE
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:VA
Mailing Address - Zip Code:22503-2607
Mailing Address - Country:US
Mailing Address - Phone:540-455-6953
Mailing Address - Fax:
Practice Address - Street 1:63 JEFFERY AVE
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:VA
Practice Address - Zip Code:22503-2607
Practice Address - Country:US
Practice Address - Phone:540-455-6953
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-14
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN8187OtherMINNESOTA CERTIFICATION BOARD
VA0710103709OtherCOMMONWEALTH OF VIRGINIA DEPARTMENT OF HEALTH PROFESSIONS