Provider Demographics
NPI:1922375666
Name:FISCHER, AMY (LCSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:FISCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4507 N STERLING AVE STE 203
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-3861
Mailing Address - Country:US
Mailing Address - Phone:309-857-6399
Mailing Address - Fax:815-844-3561
Practice Address - Street 1:4507 N STERLING AVE STE 203
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-3861
Practice Address - Country:US
Practice Address - Phone:309-857-6399
Practice Address - Fax:815-844-3561
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490155441041C0700X
IL150013093101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty