Individual provider Active NPI

Laura Danielle Fishman, LMSW, ACSW

  • Clinical Social Worker
  • Bloomfield Hills, MI
National Provider Identifier
1003034307
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
6801077690 Issued in MI
Practice address
74 W Long Lake Rd
Suite 100
Bloomfield Hills, MI 48304-2769
Phone
(248) 686-0339
Fax
(248) 220-3322
NPI assigned
Apr 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 6801077690 MI Primary

Addresses

Primary practice location

74 W Long Lake Rd
Suite 100
Bloomfield Hills, MI 48304-2769

Mailing address

74 W Long Lake Rd
Suite 100
Bloomfield Hills, MI 48304-2769
Phone (248) 686-0339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6801077690MIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1003034307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "74 W LONG LAKE RD",
            "address_2": "SUITE 100",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042769",
            "telephone_number": "248-686-0339",
            "fax_number": "248-220-3322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "74 W LONG LAKE RD",
            "address_2": "SUITE 100",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483042769",
            "telephone_number": "248-686-0339",
            "fax_number": "248-220-3322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHMAN",
        "first_name": "LAURA",
        "middle_name": "DANIELLE",
        "credential": "LMSW, ACSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801077690",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bloomfield Hills, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.