Provider Demographics
NPI:1336248327
Name:FISCHER, RICHARD M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:M
Last Name:FISCHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9795 PERRY HWY STE 120
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9700
Mailing Address - Country:US
Mailing Address - Phone:724-272-5989
Mailing Address - Fax:412-364-4281
Practice Address - Street 1:9795 PERRY HWY STE 120
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-9700
Practice Address - Country:US
Practice Address - Phone:724-272-5989
Practice Address - Fax:412-364-4281
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW002332L1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA951884Medicare ID - Type Unspecified