KRISTIN D. FISHER (NPI# 1336633635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336633635 |
| Entity Type | Individual |
| Full Name | KRISTIN D. FISHER |
| Credential | MED, LPCA |
| Practice Address |
105 Waxhaw Professional Park Dr Ste H Waxhaw NC 28173-5018 |
| Mailing Address |
641 Amanda Dr Matthews NC 28104-9398 |
| Practice Telephone | 7042560305 |
| Practice Fax Number | 7042569968 |
| Mailing Telephone | 8048364883 |
| Enumeration Date | 2018-06-20 |
| Last Update Date | 2018-06-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
A13633 | NC | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CREDENTIALING IN PROCESS | 00000000 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 641 Amanda Dr, Matthews, NC 281049398 | 8048364883 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205337441 | Kristin Louise Fisher | Nurse Practitioner | 901 Patients First Dr Ste 2500, Washington, MO 63090-4700 | 2018-02-22 |
| 1013307255 | Kristin May Fisher | Dietitian, Registered | 1900 E 9th St N, Wichita, KS 67214-3115 | 2015-01-26 |
| Street Address |
105 WAXHAW PROFESSIONAL PARK DR STE H |
| City | WAXHAW |
| State | NC |
| Zip Code | 28173-5018 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316474430 | Melody Carr | Counselor | 105 Waxhaw Professional Park Dr Ste H, Waxhaw, NC 28173-5018 | 2017-05-19 |
| 1972116580 | Katherine J Smith | Counselor | 105 Waxhaw Professional Park Dr Ste H, Waxhaw, NC 28173-5018 | 2020-08-25 |
| 1023589405 | Constance Elaine Perkins | Social Worker | 105 Waxhaw Professional Park Dr Ste H, Waxhaw, NC 28173-5018 | 2018-12-11 |
| 1891274510 | Jenna Perusek | Counselor | 105 Waxhaw Professional Park Dr Ste H, Waxhaw, NC 28173-5018 | 2018-08-13 |
| 1326567280 | Eden Bozza | Social Worker | 105 Waxhaw Professional Park Dr Ste H, Waxhaw, NC 28173-5018 | 2017-09-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033733175 | Publix North Carolina, Lp | Durable Medical Equipment & Medical Supplies | 1615 Providence Road South, Marvin, NC 28173 | 2020-06-04 |
| 1225507320 | Shane Markey Dds Ms Pllc | Dentist | 8412 New Town Rd Ste A, Waxhaw, NC 28173 | 2018-11-19 |
| 1336631514 | Suganya Nelatoor,d.d.s.,p.l.l.c. | Clinic/Center | 102 E Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2018-06-04 |
| 1184120750 | Restore Healthcare Medical Group | Counselor | 500 Waxhaw Professional Park Drive, Ste 105 F, Waxhaw, NC 28173 | 2018-04-03 |
| 1730690827 | Concrete Roses Consulting | Community/Behavioral Health | 5960 Fairview Road, 323, Charlotte, NC 28173 | 2017-10-17 |
| 1861849523 | Kayla Selena Caldwell | Social Worker | 3908 Rev. H. Morrison Rd., Waxhaw, NC 28173 | 2016-05-23 |
| 1588023782 | Teri Hipp | Counselor | 101-e Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2016-02-16 |
| 1710355508 | Caresmatic Phase 1,inc. | Assisted Living Facility | 520 Pembroke Ln., Waxhaw, NC 28173 | 2015-09-10 |
| 1437564838 | Anna Waddell Schneiderman | Counselor | 104 Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2014-06-24 |
| 1467892109 | Samantha Weidele Waldman | Counselor | 9929 Rea Rd Ste 201, Waxhaw, NC 28173 | 2013-06-26 |
| Find all providers in zip 28173 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417452665 | Tara M. Soldano-davis | Counselor | 11023 Royal Colony Dr, Waxhaw, NC 28173-6783 | 2018-03-29 |
| 1316474430 | Melody Carr | Counselor | 105 Waxhaw Professional Park Dr Ste H, Waxhaw, NC 28173-5018 | 2017-05-19 |
| 1588023782 | Teri Hipp | Counselor | 101-e Waxhaw Professional Park Drive, Waxhaw, NC 28173 | 2016-02-16 |
| 1962879338 | Kellie Marie Spear | Counselor | 8603 Dansington Ct, Waxhaw, NC 28173-6620 | 2015-09-01 |
| 1972983583 | Jill Hale | Counselor | 8220 Poplar Grove Cir, Waxhaw, NC 28173-8243 | 2015-06-09 |
| 1851714158 | Michelle Mcdevitt-askew | Counselor | 9914 New Town Rd, Waxhaw, NC 28173-8578 | 2014-01-23 |
| 1467892109 | Samantha Weidele Waldman | Counselor | 9929 Rea Rd Ste 201, Waxhaw, NC 28173 | 2013-06-26 |
| 1083053433 | Karen Degraaf | Counselor | 6709 Wycliffe Ave, Waxhaw, NC 28173 | 2013-06-19 |
| 1750633129 | Robert S Pennello Sr. | Counselor | 136 Waxhaw Pkwy Ste E110, Waxhaw, NC 28173-5029 | 2012-10-10 |
| 1164684478 | Debra L Corbett | Counselor | 8921 Cumberland Ct, Waxhaw, NC 28173-6572 | 2008-06-27 |
| Find all providers in WAXHAW | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.