Provider Demographics
NPI:1689636326
Name:FISCHER, CAROL (LISW)
Entity Type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LISW
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 634167
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:513-891-1006
Mailing Address - Fax:513-793-1032
Practice Address - Street 1:732 LILA AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-1609
Practice Address - Country:US
Practice Address - Phone:513-201-5440
Practice Address - Fax:513-766-7975
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI-00056611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHSW25901Medicare PIN
OHSW25902Medicare PIN