Provider Demographics
NPI:1568096030
Name:SUZAN M FISCHER LPC, PLLC
Entity Type:Organization
Organization Name:SUZAN M FISCHER LPC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROVIDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUZAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FISCHER
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:586-764-8867
Mailing Address - Street 1:26 BELLEVIEW ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2241
Mailing Address - Country:US
Mailing Address - Phone:586-764-8867
Mailing Address - Fax:
Practice Address - Street 1:198 S MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-7917
Practice Address - Country:US
Practice Address - Phone:586-764-8867
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-24
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty