Provider Demographics
NPI:1295896975
Name:FISHER, BRIGITTE LOURIE (MFT, LEP)
Entity type:Individual
Prefix:MRS
First Name:BRIGITTE
Middle Name:LOURIE
Last Name:FISHER
Suffix:
Gender:F
Credentials:MFT, LEP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:BERKELEY
Mailing Address - State:CA
Mailing Address - Zip Code:94705-2825
Mailing Address - Country:US
Mailing Address - Phone:510-652-5293
Mailing Address - Fax:510-420-1459
Practice Address - Street 1:919 VILLAGE CTR STE 6
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-3599
Practice Address - Country:US
Practice Address - Phone:925-284-1611
Practice Address - Fax:510-420-1459
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAM.F.T. 4338101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health