Provider Demographics
NPI:1982876561
Name:FISHER, BRANDON L (LPC)
Entity Type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:L
Last Name:FISHER
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 E SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5958
Mailing Address - Country:US
Mailing Address - Phone:620-276-7689
Mailing Address - Fax:620-276-6117
Practice Address - Street 1:1111 E SPRUCE ST
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5958
Practice Address - Country:US
Practice Address - Phone:620-276-7689
Practice Address - Fax:620-276-6117
Is Sole Proprietor?:No
Enumeration Date:2008-03-24
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC 1948101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional