Provider Demographics
NPI:1508501370
Name:FISHER, DEBORAH LEE (LMHCA)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LEE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3925 E HAGAN ST STE 307
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47401-8649
Mailing Address - Country:US
Mailing Address - Phone:206-853-5423
Mailing Address - Fax:
Practice Address - Street 1:3925 E HAGAN ST STE 307
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47401-8649
Practice Address - Country:US
Practice Address - Phone:206-853-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-04
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN88001460A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health