Provider Demographics
NPI:1891085205
Name:FISHER, CHRISTY (LMSW)
Entity Type:Individual
Prefix:
First Name:CHRISTY
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 1:500 WILLOW AVE
Mailing Address - Street 2:STE 215
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-0827
Mailing Address - Country:US
Mailing Address - Phone:402-541-5674
Mailing Address - Fax:712-256-1312
Practice Address - Street 1:500 WILLOW AVE
Practice Address - Street 2:STE 215
Practice Address - City:COUNCIL BLUFFS
Practice Address - State:IA
Practice Address - Zip Code:51503-0827
Practice Address - Country:US
Practice Address - Phone:402-541-5674
Practice Address - Fax:712-256-1312
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-19
Last Update Date:2019-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA06788104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker