Provider Demographics
NPI:1902010119
Name:FISCHER, BETSY SUE (LCSW)
Entity Type:Individual
Prefix:
First Name:BETSY
Middle Name:SUE
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3417 NW 177TH AVE
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32609-4298
Mailing Address - Country:US
Mailing Address - Phone:352-278-1222
Mailing Address - Fax:
Practice Address - Street 1:100 SW 75TH ST
Practice Address - Street 2:SUITE 107
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32607-5779
Practice Address - Country:US
Practice Address - Phone:352-331-4621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW74811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical