Provider Demographics
NPI:1336577998
Name:FISCHER, GARTH (LCPC)
Entity type:Individual
Prefix:
First Name:GARTH
Middle Name:
Last Name:FISCHER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17600 157TH ST
Mailing Address - Street 2:
Mailing Address - City:BASEHOR
Mailing Address - State:KS
Mailing Address - Zip Code:66007-7377
Mailing Address - Country:US
Mailing Address - Phone:816-308-6678
Mailing Address - Fax:
Practice Address - Street 1:3500 N 99TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66109
Practice Address - Country:US
Practice Address - Phone:913-712-9257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-17
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2796101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional