Brenda Sharalyn Fisher, MA, LCAS LPC LPC-S

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

4124 Issued in NC

Practice address

4320 Southport Supply Rd SE
Suite 300
Southport, NC 28461-8158

Phone

(910) 964-3352

Fax

(910) 842-3351

NPI assigned

Aug 9, 2005

Last updated

Sep 9, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Mrs. Brenda Sharalyn Fisher Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1123545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410220800000",
    "number": "1265433411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "428 HAMILTON DR SE",
            "city": "BOLIVIA",
            "state": "NC",
            "postal_code": "284227716",
            "telephone_number": "910-964-3352",
            "fax_number": "910-842-3351"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4320 SOUTHPORT SUPPLY RD SE",
            "address_2": "SUITE 300",
            "city": "SOUTHPORT",
            "state": "NC",
            "postal_code": "284618158",
            "telephone_number": "910-964-3352",
            "fax_number": "910-842-3351"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "BRENDA",
        "middle_name": "SHARALYN",
        "name_prefix": "Mrs.",
        "credential": "MA, LCAS LPC LPC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-08-09",
        "last_updated": "2014-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4124",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC/BS",
            "identifier": "340955",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHN",
            "identifier": "340955",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRENDA",
            "last_name": "FISHER",
            "middle_name": "SHARALYN",
            "prefix": "MRS.",
            "credential": "LPC LCAS LPC-S",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Laura Elson, PT
• Emergeortho, PA
• Christina Valvano England, PT
• Eric L. Cole MD, PA
• Michael Zamudio Anthony Fernandez, DPT
• Garrett James Fitzgibbons, PT
• Janice Hare Florio, OTRL
• Mark D Foster, MD
• Cynthia N Frazier, MD
• Denice Frette, RPH

• Professional Counselor in Southport, NC
• Providers in Southport, NC by specialty
• Professional Counselor in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.