Bruce R Fisher, MSW LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1634 Issued in MN

Practice address

2550 University Ave W
Suite 435 S.
Saint Paul, MN 55114-1052

Phone

(651) 647-1900

Fax

(651) 647-1861

NPI assigned

Feb 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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.

• Pathway Virtu-Health

  • Family Nurse Practitioner
  • Shoreview, MN
  • NPI 1073134284
  NPD (past)

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1390780800000",
    "number": "1235104084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3310 NICOLLET AVE",
            "address_2": "#406",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554084495",
            "telephone_number": "612-309-5965",
            "fax_number": "651-647-1861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 435 S.",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "651-647-1900",
            "fax_number": "651-647-1861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "BRUCE",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "MSW LICSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2014-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "1634",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "968557000",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fish Psychotherapy & Consulting
• Bryan Fish, LADC
• Jillian Fish, PHD, LP
• Katherine Joyce Fishel, SLP
• Alison Fisher, PHARMD
• Deborah E Fisher, PSY D. L.P.
• Janet E Fisher, MA LP
• Kenneth C Fisher, CRNA
• Nancy A Fisher, DO
• Rashida Karriem Fisher, LPCC, LADC

• Clinical Social Worker in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Clinical Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2014; 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.