Provider Demographics
NPI:1952637423
Name:CHRISTIAN FISHER P- LLC
Entity Type:Organization
Organization Name:CHRISTIAN FISHER P- LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:CHRISTIAN
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:919-883-7771
Mailing Address - Street 1:PO BOX 755
Mailing Address - Street 2:
Mailing Address - City:PITTSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27312-0755
Mailing Address - Country:US
Mailing Address - Phone:919-883-7771
Mailing Address - Fax:919-695-0079
Practice Address - Street 1:310 WEST ST
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-9448
Practice Address - Country:US
Practice Address - Phone:919-883-7771
Practice Address - Fax:919-695-0079
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2023-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCCOO4628251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health