Individual provider Active NPI

Stuart G Fisher, PH.D.

  • Family Psychologist
  • Worcester, MA
National Provider Identifier
1285799965
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family PsychologistTaxonomy code 103TF0000X
License
2912 Issued in MA
Practice address
124 Newton Ave N
Worcester, MA 01609-1404
Phone
(508) 755-4557
Fax
(508) 791-5135
NPI assigned
Dec 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2912 MA
Clinical Child & Adolescent Psychologist 103TC2200X 2912 MA
Family Psychologist 103TF0000X 2912 MA Primary
Health Service Psychologist 103TH0100X 2912 MA

Addresses

Primary practice location

124 Newton Ave N
Worcester, MA 01609-1404

Mailing address

124 Newton Ave N
Worcester, MA 01609-1404
Phone (508) 755-4557

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)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2912MAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1166918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1285799965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 NEWTON AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091404",
            "telephone_number": "508-755-4557",
            "fax_number": "508-791-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 NEWTON AVE N",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091404",
            "telephone_number": "508-755-4557",
            "fax_number": "508-791-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "STUART",
        "middle_name": "G",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-24",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "2912",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "2912",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MA",
            "license": "2912",
            "primary": true
        },
        {
            "code": "103TH0100X",
            "taxonomy_group": "",
            "desc": "Psychologist, Health Service",
            "state": "MA",
            "license": "2912",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.