Provider Demographics
NPI:1457548059
Name:FISHER, CHERYL YVONNE (MS NCC LGPC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:YVONNE
Last Name:FISHER
Suffix:
Gender:F
Credentials:MS NCC LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 NIMITZ DR
Mailing Address - Street 2:
Mailing Address - City:ANNAPOLIS
Mailing Address - State:MD
Mailing Address - Zip Code:21401
Mailing Address - Country:US
Mailing Address - Phone:443-223-5889
Mailing Address - Fax:
Practice Address - Street 1:645 BALTIMORE-ANNAPOLIS BLVD
Practice Address - Street 2:SUITE 107
Practice Address - City:SEVERNA PARK
Practice Address - State:MD
Practice Address - Zip Code:21146
Practice Address - Country:US
Practice Address - Phone:443-223-5889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP400101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor