Provider Demographics
NPI:1932686359
Name:FISHER, BRITTANY ROCHELLE (LCSW)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:ROCHELLE
Last Name:FISHER
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 1:400 SOUTHLAKE BLVD STE J1
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23236-3075
Mailing Address - Country:US
Mailing Address - Phone:804-986-7526
Mailing Address - Fax:
Practice Address - Street 1:400 SOUTHLAKE BLVD STE J1
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23236-3075
Practice Address - Country:US
Practice Address - Phone:804-986-7526
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-27
Last Update Date:2021-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2793-05-001101YM0800X
VA09040111651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health