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Individual

JARVIA LYNN FISHELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
33108 LIGHTHOUSE RD, SELBYVILLE, DE 19975-4018
(443) 229-7400
Mailing address
33108 LIGHTHOUSE RD, SELBYVILLE, DE 19975-4018
(302) 436-5247

Taxonomy

Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
LC0742
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
259147-000
MAGELLAN BEHAVIORAL HEALTH
MD
05
609550001
MD
01
7840093
AETNA
MD
01
R968
CAREFIRST BCBS
MD
Enumeration date
12/07/2007
Last updated
12/06/2021
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