1104242874 NPI number — FISCHER COUNSELING

Table of content: (NPI 1104242874)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104242874 NPI number — FISCHER COUNSELING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FISCHER COUNSELING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1104242874
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/05/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
103 N MINNESOTA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HASTINGS
Provider Business Mailing Address State Name:
NE
Provider Business Mailing Address Postal Code:
68901-5212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
402-469-7271
Provider Business Mailing Address Fax Number:
402-463-0019

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
103 N MINNESOTA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HASTINGS
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68901-5212
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-469-7271
Provider Business Practice Location Address Fax Number:
402-463-0019
Provider Enumeration Date:
03/05/2014

Additional Information

Authorized Official

Authorized Official Last Name:
FISCHER
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
DARLENE
Authorized Official Title or Position:
THERAPIST
Authorized Official Telephone Number:
402-469-7271

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  3728 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 10025900500 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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