Provider Demographics
NPI:1538790530
Name:FISCHER, KELLY (LMHC)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 CEDAR HEIGHTS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR FALLS
Mailing Address - State:IA
Mailing Address - Zip Code:50613-6041
Mailing Address - Country:US
Mailing Address - Phone:319-318-1205
Mailing Address - Fax:
Practice Address - Street 1:3301 CEDAR HEIGHTS DR
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6041
Practice Address - Country:US
Practice Address - Phone:319-318-1205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-28
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA097264101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health