Provider Demographics
NPI:1821533365
Name:FISHER, DONDRA (LMSW)
Entity Type:Individual
Prefix:
First Name:DONDRA
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMSW
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 2578
Mailing Address - Street 2:
Mailing Address - City:GRETNA
Mailing Address - State:LA
Mailing Address - Zip Code:70054-2578
Mailing Address - Country:US
Mailing Address - Phone:504-371-6770
Mailing Address - Fax:504-322-7708
Practice Address - Street 1:1400 CALDER ST
Practice Address - Street 2:
Practice Address - City:GRETNA
Practice Address - State:LA
Practice Address - Zip Code:70053-5637
Practice Address - Country:US
Practice Address - Phone:504-322-7710
Practice Address - Fax:504-322-7708
Is Sole Proprietor?:No
Enumeration Date:2016-12-19
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6959171M00000X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator