Provider Demographics
NPI:1245060599
Name:FISHER, ALIA D (MA, LPC)
Entity type:Individual
Prefix:
First Name:ALIA
Middle Name:D
Last Name:FISHER
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 DIAMOND DR
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80504-7746
Mailing Address - Country:US
Mailing Address - Phone:303-775-8030
Mailing Address - Fax:
Practice Address - Street 1:3609 S WADSWORTH BLVD
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80235-2108
Practice Address - Country:US
Practice Address - Phone:303-902-3068
Practice Address - Fax:303-484-3943
Is Sole Proprietor?:No
Enumeration Date:2024-08-02
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018524101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional