Provider Demographics
NPI:1942933536
Name:FISHER, DESIREE TANEE (LCMHCA, NCC)
Entity Type:Individual
Prefix:
First Name:DESIREE
Middle Name:TANEE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 GLOSSY LEAF PL
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27712-9509
Mailing Address - Country:US
Mailing Address - Phone:919-410-8202
Mailing Address - Fax:
Practice Address - Street 1:1 GLOSSY LEAF PL
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27712-9509
Practice Address - Country:US
Practice Address - Phone:919-410-8202
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-01
Last Update Date:2022-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA17550101Y00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor