Provider Demographics
NPI:1073267381
Name:DEANA L. FISHER, P.C.
Entity type:Organization
Organization Name:DEANA L. FISHER, P.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:DEANA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:773-680-4011
Mailing Address - Street 1:7215 W 113TH ST
Mailing Address - Street 2:
Mailing Address - City:WORTH
Mailing Address - State:IL
Mailing Address - Zip Code:60482-1709
Mailing Address - Country:US
Mailing Address - Phone:773-680-4011
Mailing Address - Fax:
Practice Address - Street 1:8102 W 119TH ST STE 1030
Practice Address - Street 2:
Practice Address - City:PALOS PARK
Practice Address - State:IL
Practice Address - Zip Code:60464-3081
Practice Address - Country:US
Practice Address - Phone:773-680-4011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-06
Last Update Date:2024-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty