Active NPI
Amy L. H. Fish, PH.D.
- Psychologist
- Minneapolis, MN
National Provider Identifier
1487278636
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- LP6537
- Practice address
- 1315 E 24TH St
Minneapolis, MN 55404-3975 - Phone
- (612) 721-9811
- NPI assigned
- Jun 3, 2020
- 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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | LP6537 | MN | Primary |
Addresses
Primary practice location
1315 E 24TH St
Minneapolis, MN 55404-3975
Mailing address
1315 E 24TH St
Minneapolis, MN 55404-3975
Phone (612) 721-9877
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 3, 2024 through Oct 3, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP6537 | MN | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629244800000",
"number": "1487278636",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1315 E 24TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554043975",
"telephone_number": "612-721-9877"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1315 E 24TH ST",
"city": "MINNEAPOLIS",
"state": "MN",
"postal_code": "554043975",
"telephone_number": "612-721-9811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISH",
"first_name": "AMY",
"middle_name": "L. H.",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-03",
"last_updated": "2021-08-18",
"certification_date": "2021-08-18",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "MN",
"license": "LP6537",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Minneapolis, MN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.