Provider Demographics
NPI:1578741104
Name:FISHER, SEBERN (MA)
Entity Type:Individual
Prefix:MS
First Name:SEBERN
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ELIZABETH ST
Mailing Address - Street 2:
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-2320
Mailing Address - Country:US
Mailing Address - Phone:413-586-4230
Mailing Address - Fax:
Practice Address - Street 1:34 ELIZABETH ST
Practice Address - Street 2:
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-2320
Practice Address - Country:US
Practice Address - Phone:413-586-4230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-06
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA721101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health