Provider Demographics
NPI:1528289584
Name:FISHER, JAY CALDWELL (LCSW-C)
Entity type:Individual
Prefix:MR
First Name:JAY
Middle Name:CALDWELL
Last Name:FISHER
Suffix:
Gender:M
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 WESTBURY RD
Mailing Address - Street 2:
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-5540
Mailing Address - Country:US
Mailing Address - Phone:410-961-4595
Mailing Address - Fax:
Practice Address - Street 1:104 WESTBURY RD
Practice Address - Street 2:
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-5540
Practice Address - Country:US
Practice Address - Phone:410-961-4595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-01
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD070681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical