Provider Demographics
NPI:1649958398
Name:JULIE FISHER LCSWR LLC
Entity type:Organization
Organization Name:JULIE FISHER LCSWR LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LCSWR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:518-704-6688
Mailing Address - Street 1:752 UPPER GLEN ST # 1004
Mailing Address - Street 2:
Mailing Address - City:QUEENSBURY
Mailing Address - State:NY
Mailing Address - Zip Code:12804-2019
Mailing Address - Country:US
Mailing Address - Phone:518-704-6688
Mailing Address - Fax:518-379-0609
Practice Address - Street 1:2 LOCARNO RD
Practice Address - Street 2:
Practice Address - City:LAKE LUZERNE
Practice Address - State:NY
Practice Address - Zip Code:12846
Practice Address - Country:US
Practice Address - Phone:518-704-6688
Practice Address - Fax:518-379-0609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-11
Last Update Date:2023-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty