Kandi Burr-Fisher, LP

Primary specialty

PsychologistTaxonomy code 103T00000X

License

200610 Issued in MN

Practice address

26246 Crane Road
White Earth, MN 56591

Phone

(218) 983-4703

Fax

(218) 983-4236

NPI assigned

Dec 9, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• White Earth Band of Chippewa

  • Community/Behavioral Health Agency
  • White Earth, MN
  • NPI 1093898660
  NPD (past)

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

{
    "created_epoch": "1449619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449619200000",
    "number": "1275908709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 300",
            "city": "WHITE EARTH",
            "state": "MN",
            "postal_code": "565910300",
            "telephone_number": "218-983-4703",
            "fax_number": "218-983-4236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26246 CRANE ROAD",
            "city": "WHITE EARTH",
            "state": "MN",
            "postal_code": "56591",
            "telephone_number": "218-983-4703",
            "fax_number": "218-983-4236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURR-FISHER",
        "first_name": "KANDI",
        "name_prefix": "Mrs.",
        "credential": "LP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-09",
        "last_updated": "2015-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "200610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beverly Gay Anderson, LPCC, LADC
• Grant Justin Atwood, MS, LPCC
• Byllie Jean Gwyn Beck, LICSW
• Angela Marie Bellanger, LICSW
• Katy Jo Braaten, LICSW
• Tina Ann Heisler, M.S., L.P.
• Willy Ann Heisler, S.W.
• Katie Lynn Hoban, RDN, LD
• Jacqueline Jacobson, LPCC
• Sarah Jane Jasken, M.S.W; LICSW

• All providers in White Earth, MN
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2015; 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.