Jennifer H Fisher, LCPC

Individual provider Active NPI Professional Counselor · Portland, ME

NPI 1285065730 · NPPES record last updated May 12, 2017

Key facts

NPI
1285065730
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
CC4828 (ME)
Practice address
125 Presumpscot St
Portland, ME 04103-5225
Phone
(207) 650-4040
NPI assigned
Dec 10, 2013
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
CC4828MEMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC4828 ME Yes

Addresses

Primary practice location

125 Presumpscot St
Portland, ME 04103-5225

Mailing address

125 Presumpscot St
Portland, ME 04103-5225
Phone (207) 650-4040

Other providers in Portland, ME

All providers in Portland, ME · Professional Counselor in Maine

Sources for this page

Verify at the official NPI Registry.