Basic Information
| Provider Information | |||||||||
| NPI: | 1457371064 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISER | ||||||||
| FirstName: | CHERYL | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | LCSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 40908 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283090908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106156949 | ||||||||
| FaxNumber: | 9106159761 | ||||||||
| Practice Location | |||||||||
| Address1: | 711 EXECUTIVE PL FL 4 | ||||||||
| Address2: | |||||||||
| City: | FAYETTEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 283055193 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9106153333 | ||||||||
| FaxNumber: | 9106159765 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/20/2006 | ||||||||
| LastUpdateDate: | 06/21/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | I0008736 | OH | N | Behavioral Health & Social Service Providers | Social Worker | 1041C0700X | C007215 | NC | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.