Provider Demographics
NPI:1396200036
Name:FISHER, ANNALEISE (MED, LPCC)
Entity type:Individual
Prefix:MRS
First Name:ANNALEISE
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:MED, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1222 KEEFER RD
Mailing Address - Street 2:
Mailing Address - City:GIRARD
Mailing Address - State:OH
Mailing Address - Zip Code:44420-1426
Mailing Address - Country:US
Mailing Address - Phone:330-219-2917
Mailing Address - Fax:
Practice Address - Street 1:960 GRAHAM RD STE 3
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-1155
Practice Address - Country:US
Practice Address - Phone:330-333-8381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-06
Last Update Date:2022-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1700596101YM0800X
OHE.2202789101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health