Provider Demographics
NPI:1760947949
Name:FISHER, REBEKAH M (MA, LPC)
Entity Type:Individual
Prefix:MRS
First Name:REBEKAH
Middle Name:M
Last Name:FISHER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 MELWOOD AVE APT 304
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15213-1339
Mailing Address - Country:US
Mailing Address - Phone:724-456-3907
Mailing Address - Fax:
Practice Address - Street 1:157 S 26TH ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15203-2242
Practice Address - Country:US
Practice Address - Phone:724-456-3907
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-01
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011960101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAPC011960OtherPROFESSIONAL LICENSE