Nicole Paulina Fisher, MA, LAC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

37AC00611800 Issued in NJ

Practice address

66 N Main St
Medford, NJ 08055-2719

Phone

(609) 714-8400

NPI assigned

Nov 16, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jun 14, 2024 through Jun 14, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Center for Counseling and Education of Medford

  • Professional Counselor
  • Medford, NJ
  • NPI 1942692389
  NPD (past)

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

{
    "created_epoch": "1637020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637020800000",
    "number": "1194481960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 N MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552719",
            "telephone_number": "609-714-8400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 N MAIN ST",
            "city": "MEDFORD",
            "state": "NJ",
            "postal_code": "080552719",
            "telephone_number": "609-714-8400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "NICOLE",
        "middle_name": "PAULINA",
        "credential": "MA, LAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-11-16",
        "last_updated": "2021-11-16",
        "certification_date": "2021-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "37AC00611800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amerigo J Fedeli, DMD
• Brian Feingold
• Felicia R. Neubauer, M.S.W.,L.C.S.W.,L.L.C.
• Robin Maxwell Fields, RPH
• Henry Wilson Finger, D.D.S.
• Courtney Warren Flank, MS, LPC, NCC
• Beth Fleischman, L.C.S.W.
• Foot Health Centers, P.a.
• Footworks LLC
• Daniel J Foran, DO

• Mental Health Counselor in Medford, NJ
• Providers in Medford, NJ by specialty
• Mental Health Counselor in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.