Provider Demographics
NPI:1295879609
Name:RISHER, CAROL ANN (LPC)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:ANN
Last Name:RISHER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5158 STAGE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38134-3116
Mailing Address - Country:US
Mailing Address - Phone:901-377-5646
Mailing Address - Fax:901-377-9866
Practice Address - Street 1:5158 STAGE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38134-3116
Practice Address - Country:US
Practice Address - Phone:901-377-5646
Practice Address - Fax:901-377-9866
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000682101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional