Basic Information
| Provider Information | |||||||||
| NPI: | 1679909410 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FISCHER | ||||||||
| FirstName: | KRISTIN | ||||||||
| MiddleName: | SWEET | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | MA, LMFT | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | MCGEE | ||||||||
| OtherFirstName: | KRISTIN | ||||||||
| OtherMiddleName: | SWEET | ||||||||
| OtherNamePrefix: | |||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | KRISTIN SWEET MCGEE | ||||||||
| OtherLastNameType: | 1 | ||||||||
| Mailing Information | |||||||||
| Address1: | 3118 N 31ST ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984076411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532003908 | ||||||||
| FaxNumber: | 2532920434 | ||||||||
| Practice Location | |||||||||
| Address1: | 3118 N 31ST ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984076411 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2532003908 | ||||||||
| FaxNumber: | 2532920434 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2013 | ||||||||
| LastUpdateDate: | 04/01/2021 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
| AuthorizedOfficialLastName: | |||||||||
| AuthorizedOfficialFirstName: | |||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | Y | ||||||||
| IsOrganizationSubpart: | |||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 04/01/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | CG0416666 | WA | N | Behavioral Health & Social Service Providers | Counselor | 102L00000X | LF60755871 | WA | N | Behavioral Health & Social Service Providers | Psychoanalyst | 106H00000X | LF60755871 | WA | Y | Behavioral Health & Social Service Providers | Marriage & Family Therapist |
No ID Information.