Provider Demographics
NPI:1578905097
Name:FEHR, LISA (LMHC NCC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:FEHR
Suffix:
Gender:F
Credentials:LMHC NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 394
Mailing Address - Street 2:
Mailing Address - City:DAKOTA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:50529-0394
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:202 MAIN ST
Practice Address - Street 2:
Practice Address - City:DAKOTA CITY
Practice Address - State:IA
Practice Address - Zip Code:50529-5063
Practice Address - Country:US
Practice Address - Phone:515-576-7388
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-25
Last Update Date:2015-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001610101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health