Michael Jacob Fisher, CSAC-S,

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

3208 Hershberger Rd NW
Roanoke, VA 24017-1842

Phone

(540) 202-2402

Fax

(540) 563-3084

NPI assigned

Mar 24, 2022

Sex

Male

Sole proprietor

Yes

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

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

{
    "created_epoch": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648080000000",
    "number": "1366192452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2306 LONGVIEW AVE SW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240141614",
            "telephone_number": "603-978-9032"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3208 HERSHBERGER RD NW",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240171842",
            "telephone_number": "540-202-2402",
            "fax_number": "540-563-3084"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "MICHAEL",
        "middle_name": "JACOB",
        "credential": "CSAC-S,",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-03-24",
        "last_updated": "2022-03-24",
        "certification_date": "2022-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• First Light Clinic LLC
• Suzanne W Fischer, CNP
• Amy Katelyn Fisher, CRNA
• Jennifer Lynn Fisher, OTR/L
• Matthew Fisher, CRNA, RN
• David Kyle Fitzgerald, DDS
• Jenna R Fitzgerald, PHD LPC
• Kiley F Fitzgerald, MD
• Mary Fitzgerald, CRNA
• Fielding Carter Fitzpatrick, DO

• Addiction (Substance Use Disorder) Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Addiction (Substance Use Disorder) Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 24, 2022; 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.