1528099249 NPI number — BETSY LOUISE FISHER LMFT

Table of content: (NPI 1558864819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528099249 NPI number — BETSY LOUISE FISHER LMFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FISHER
Provider First Name:
BETSY
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMFT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VEDDER
Provider Other First Name:
BETSY
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528099249
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
301 AUSTIN BLUFFS PKWY
Provider Second Line Business Mailing Address:
PULPIT ROCK CHURCH
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80918-3922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-535-0969
Provider Business Mailing Address Fax Number:
719-598-1168

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
301 AUSTIN BLUFFS PKWY
Provider Second Line Business Practice Location Address:
PULPIT ROCK CHURCH
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80918-3922
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-535-0969
Provider Business Practice Location Address Fax Number:
719-598-1168
Provider Enumeration Date:
07/05/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 106H00000X , with the licence number:  CO 240 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)