Provider Demographics
NPI:1487800793
Name:FISHER, CHINITA WHITAKER (MSW, P-LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHINITA
Middle Name:WHITAKER
Last Name:FISHER
Suffix:
Gender:F
Credentials:MSW, P-LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 RAMSEY STREET
Mailing Address - Street 2:FAYETTEVILLE VA MEDICAL CENTER
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28301
Mailing Address - Country:US
Mailing Address - Phone:910-488-2120
Mailing Address - Fax:910-482-5117
Practice Address - Street 1:2300 RAMSEY ST
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28301-3856
Practice Address - Country:US
Practice Address - Phone:910-488-2120
Practice Address - Fax:910-482-5117
Is Sole Proprietor?:No
Enumeration Date:2008-08-18
Last Update Date:2008-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP004207104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker