Provider Demographics
NPI:1720383292
Name:FISCHER, RYAN JASON (LPC)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:JASON
Last Name:FISCHER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PURDUE PL
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-1231
Mailing Address - Country:US
Mailing Address - Phone:856-816-0604
Mailing Address - Fax:
Practice Address - Street 1:2 PURDUE PL
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-1231
Practice Address - Country:US
Practice Address - Phone:856-816-0604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-14
Last Update Date:2022-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00402800101YM0800X
NJNJ37PC00402800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional