Provider Demographics
NPI:1922237304
Name:FISHER, ROBERT NICHOLS (LMFT, CART)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:NICHOLS
Last Name:FISHER
Suffix:
Gender:M
Credentials:LMFT, CART
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 792231
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78279-2231
Mailing Address - Country:US
Mailing Address - Phone:210-872-1828
Mailing Address - Fax:
Practice Address - Street 1:6315 BARTON MILL ST
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78233-4602
Practice Address - Country:US
Practice Address - Phone:210-872-1828
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX4962106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist