Provider Demographics
NPI:1386980290
Name:RISHER, HOWARD BRANDON (MA, LPA)
Entity type:Individual
Prefix:MR
First Name:HOWARD
Middle Name:BRANDON
Last Name:RISHER
Suffix:
Gender:M
Credentials:MA, LPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2210 SUMNER GREEN AVE.
Mailing Address - Street 2:UNIT O
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28203
Mailing Address - Country:US
Mailing Address - Phone:704-763-6608
Mailing Address - Fax:
Practice Address - Street 1:5970 FAIRVIEW RD
Practice Address - Street 2:SUITE 420
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28210
Practice Address - Country:US
Practice Address - Phone:704-763-6608
Practice Address - Fax:704-554-9956
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-20
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4582103T00000X
NC103TF0000X, 102L00000X, 103T00000X, 103TC1900X, 103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent