Provider Demographics
NPI:1881978807
Name:FISHER, NATHAN S (LPCC)
Entity type:Individual
Prefix:MR
First Name:NATHAN
Middle Name:S
Last Name:FISHER
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 CLIFTY ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42503-1710
Mailing Address - Country:US
Mailing Address - Phone:606-678-0026
Mailing Address - Fax:606-678-0026
Practice Address - Street 1:600 CLIFTY ST STE 2
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503
Practice Address - Country:US
Practice Address - Phone:606-678-0026
Practice Address - Fax:606-678-0047
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0964101YM0800X
KY166819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1881978807OtherNPI (NATE FISHER)
KY7100446820Medicaid
KY7100395100Medicaid
KY1215475561OtherNPI (QUEST COUNSELING, LLC)