Individual provider Active NPI

Charlene Fisher

  • Mental Health Counselor
  • Los Angeles, CA
National Provider Identifier
1922406818
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
AMFT119007 Issued in CA
Practice address
5849 Crocker St Unit L
Los Angeles, CA 90003-1311
Phone
(323) 234-4445
Fax
(323) 234-4445
NPI assigned
Dec 9, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X RAS II-F1011091055 CA
Mental Health Counselor 101YM0800X AMFT119007 CA Primary

Addresses

Primary practice location

5849 Crocker St Unit L
Los Angeles, CA 90003-1311

Mailing address

5849 Crocker St Unit L
Los Angeles, CA 90003-1311
Phone (323) 234-4445

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RAS II-F1011091055CAMDAddiction (Substance Use Disorder) Counselor
AMFT119007CAMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1418083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1922406818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5849 CROCKER ST UNIT L",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031311",
            "telephone_number": "323-234-4445",
            "fax_number": "323-234-4445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5849 CROCKER ST UNIT L",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900031311",
            "telephone_number": "323-234-4445",
            "fax_number": "323-234-4445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "CHARLENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-09",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": "RAS II-F1011091055",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "AMFT119007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Angeles, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; 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.