1356893143 NPI number — MRS. CASSIDY FISCHER PALMISANO LPC

Table of content: MRS. CASSIDY FISCHER PALMISANO LPC (NPI 1356893143)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356893143 NPI number — MRS. CASSIDY FISCHER PALMISANO LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PALMISANO
Provider First Name:
CASSIDY
Provider Middle Name:
FISCHER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FISCHER
Provider Other First Name:
CASSIDY
Provider Other Middle Name:
ELLEN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356893143
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1505 N FLORIDA ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COVINGTON
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70433-1544
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
859-900-1626
Provider Business Mailing Address Fax Number:
504-885-0400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1505 N FLORIDA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COVINGTON
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70433-1544
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
859-900-1626
Provider Business Practice Location Address Fax Number:
504-885-0400
Provider Enumeration Date:
10/27/2016

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 7045 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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