Provider Demographics
NPI:1154571610
Name:FISCHLER, SAMUEL (LCSW-C)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:FISCHLER
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6514 EDENVALE RD
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2721
Mailing Address - Country:US
Mailing Address - Phone:443-388-6268
Mailing Address - Fax:
Practice Address - Street 1:1212 YORK RD
Practice Address - Street 2:SUITE A302
Practice Address - City:LUTHERVILLE
Practice Address - State:MD
Practice Address - Zip Code:21093-6240
Practice Address - Country:US
Practice Address - Phone:443-693-7228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-22
Last Update Date:2014-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD188751041C0700X
NY08046211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical