Provider Demographics
NPI:1831909738
Name:FISHER, ANDREA KRISTINE (LMFTA)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:KRISTINE
Last Name:FISHER
Suffix:
Gender:F
Credentials:LMFTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1624 BONNIE LN
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46142-1319
Mailing Address - Country:US
Mailing Address - Phone:317-517-2369
Mailing Address - Fax:
Practice Address - Street 1:902 INDIANAPOLIS RD
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46158-1156
Practice Address - Country:US
Practice Address - Phone:317-361-5281
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN85000575A106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist