Provider Demographics
NPI:1215323175
Name:FISCHER, MISTY (LMHC)
Entity type:Individual
Prefix:
First Name:MISTY
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5272 KERNWOOD CT
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34685-3627
Mailing Address - Country:US
Mailing Address - Phone:727-267-6247
Mailing Address - Fax:
Practice Address - Street 1:7747 MITCHELL BLVD
Practice Address - Street 2:SUITE #B
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34655-4725
Practice Address - Country:US
Practice Address - Phone:727-267-6247
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-07
Last Update Date:2015-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH12968101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health