Provider Demographics
NPI:1124272828
Name:FISHER-LAROCHE, CORINNE (LCSW)
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:
Last Name:FISHER-LAROCHE
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 1:4040 SUMMER BROOK DR
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27539-5705
Mailing Address - Country:US
Mailing Address - Phone:919-271-9684
Mailing Address - Fax:
Practice Address - Street 1:160 NE MAYNARD RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-9670
Practice Address - Country:US
Practice Address - Phone:919-466-7540
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0060191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical