Provider Demographics
NPI:1720223829
Name:FISHER, SUZANNE RENEE (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:SUZANNE
Middle Name:RENEE
Last Name:FISHER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:KIRK
Other - Last Name:ARNOLD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 106
Mailing Address - Street 2:
Mailing Address - City:KIMBERTON
Mailing Address - State:PA
Mailing Address - Zip Code:19442-0106
Mailing Address - Country:US
Mailing Address - Phone:484-678-2104
Mailing Address - Fax:
Practice Address - Street 1:2102 KIMBERTON RD.
Practice Address - Street 2:
Practice Address - City:PHOENIXVILLE
Practice Address - State:PA
Practice Address - Zip Code:19460
Practice Address - Country:US
Practice Address - Phone:484-678-2104
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-04
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC053697001041C0700X
PACW-0157601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical