Provider Demographics
NPI:1063118040
Name:FISHER, SAMANTHA LEANN (LCSW)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LEANN
Last Name:FISHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:725 SKYLINE DR
Mailing Address - Street 2:
Mailing Address - City:SEARCY
Mailing Address - State:AR
Mailing Address - Zip Code:72143-6536
Mailing Address - Country:US
Mailing Address - Phone:501-593-7152
Mailing Address - Fax:
Practice Address - Street 1:305 S PALM ST
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-5432
Practice Address - Country:US
Practice Address - Phone:501-251-6653
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-01
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR11146-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical