Active NPI
Carly Catherine Fisher, LSW
- Social Worker
- Chicago, IL
National Provider Identifier
1356112650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 150.111929
- Practice address
- 3166 N Lincoln Ave Ste 401
Chicago, IL 60657-3181 - Phone
- (630) 777-7669
- NPI assigned
- Jan 15, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 150.111929 | IL | Primary |
Addresses
Primary practice location
3166 N Lincoln Ave Ste 401
Chicago, IL 60657-3181
Mailing address
355 N Halsted St Apt 413
Chicago, IL 60661-2346
Phone (630) 777-7669
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
| License | State | Type | Specialty |
|---|---|---|---|
| 150.111929 | IL | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1705276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705276800000",
"number": "1356112650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "355 N HALSTED ST APT 413",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606612346",
"telephone_number": "630-777-7669"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3166 N LINCOLN AVE STE 401",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606573181",
"telephone_number": "630-777-7669"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "CARLY",
"middle_name": "CATHERINE",
"credential": "LSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-01-15",
"last_updated": "2024-01-15",
"certification_date": "2024-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "IL",
"license": "150.111929",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.