Provider Demographics
NPI:1982954798
Name:FISCHETTI, BRENDA L (MA, LPC)
Entity Type:Individual
Prefix:
First Name:BRENDA
Middle Name:L
Last Name:FISCHETTI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STATION WAY RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:CHADDS FORD
Mailing Address - State:PA
Mailing Address - Zip Code:19317-9782
Mailing Address - Country:US
Mailing Address - Phone:484-840-3674
Mailing Address - Fax:610-889-0732
Practice Address - Street 1:2 STATION WAY RD
Practice Address - Street 2:SUITE 1
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317-9782
Practice Address - Country:US
Practice Address - Phone:484-840-3674
Practice Address - Fax:610-889-0732
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-19
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC006486101YP2500X
PA101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional