Individual provider Active NPI

Phoebe M Fiddler, LICSW

  • Clinical Social Worker
  • Northampton, MA
National Provider Identifier
1366432072
Registry record updated Sep 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LICSW103057 Issued in MA
Practice address
241 King St
Suite 230
Northampton, MA 01060
Phone
(413) 695-7861
NPI assigned
Oct 24, 2005
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2019

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 LICSW103057 MA Primary

Addresses

Primary practice location

241 King St
Suite 230
Northampton, MA 01060

Mailing address

103 Massasoit St
Northampton, MA 01060
Phone (413) 695-7861

Other names 1

  • Ms. Peggy Fiddler Other name

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

State licenses

LicenseStateTypeSpecialty
LICSW103057MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569456000000",
    "number": "1366432072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 MASSASOIT ST",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "01060",
            "telephone_number": "413-695-7861"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 KING ST",
            "address_2": "SUITE 230",
            "city": "NORTHAMPTON",
            "state": "MA",
            "postal_code": "01060",
            "telephone_number": "413-695-7861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDDLER",
        "first_name": "PHOEBE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-10-24",
        "last_updated": "2019-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "LICSW103057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PEGGY",
            "last_name": "FIDDLER",
            "prefix": "MS.",
            "credential": "LICSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Northampton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2019; 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.