Individual
THAD WILLIAM FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, M.DIV.
Contact information
Practice address
6417 W IRVING PARK RD, CHICAGO, IL 60634-2437
(773) 777-7112
Mailing address
6417 W IRVING PARK RD, CHICAGO, IL 60634-2437
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
101YP1600X
Pastoral Counselor
—
—
101YP2500X
Professional Counselor
—
—
374K00000X
Religious Nonmedical Practitioner
—
—
Other
Enumeration date
05/19/2017
Last updated
05/19/2017
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