Provider Demographics
NPI:1679812515
Name:FISHER, ANDREA ELIZABETH (LCPC)
Entity type:Individual
Prefix:
First Name:ANDREA
Middle Name:ELIZABETH
Last Name:FISHER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 AURORA AVE
Mailing Address - Street 2:
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-6266
Mailing Address - Country:US
Mailing Address - Phone:630-646-8000
Mailing Address - Fax:630-646-8007
Practice Address - Street 1:440 AURORA AVE
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-6266
Practice Address - Country:US
Practice Address - Phone:630-646-8000
Practice Address - Fax:630-646-8007
Is Sole Proprietor?:No
Enumeration Date:2013-02-13
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
180010033101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional