Provider Demographics
NPI:1639168370
Name:FISCHER, KATHY ANN (LMHP, LPC)
Entity type:Individual
Prefix:
First Name:KATHY
Middle Name:ANN
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LMHP, LPC
Other - Prefix:
Other - First Name:KATE
Other - Middle Name:
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHP, LPC
Mailing Address - Street 1:11330 Q ST
Mailing Address - Street 2:OMAHA
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68137-3679
Mailing Address - Country:US
Mailing Address - Phone:402-597-2312
Mailing Address - Fax:402-597-2349
Practice Address - Street 1:11330 Q ST
Practice Address - Street 2:OMAHA
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68137-3679
Practice Address - Country:US
Practice Address - Phone:402-597-2312
Practice Address - Fax:402-597-2349
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2259101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025348900Medicaid