Active NPI
Charles Fisch, M.S.W.
- Clinical Social Worker
- Brooklyn, NY
National Provider Identifier
1487852521
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 017884-R
- Practice address
- 425 Kings Hwy
Brooklyn, NY 11223-1629 - Phone
- (718) 787-1100
- NPI assigned
- Jul 10, 2007
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 017884-R | NY | Primary |
Addresses
Primary practice location
425 Kings Hwy
Brooklyn, NY 11223-1629
Mailing address
1623 3Rd Ave Apt 18F
New York, NY 10128-3641
Phone (917) 374-0009
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02858684 | Medicaid | NY |
Other names 1
- Mr. Charles Fisch
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
| License | State | Type | Specialty |
|---|---|---|---|
| 017884-R | NY | MD | Clinical Social Worker |
| 017884 | NY | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| SBH Community Service Network, Inc. | Past | Accepting new patients | |
| Sephardic Bikur Holim | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Community/Behavioral Health Agency
- Brooklyn, NY
- NPI 1104966829
-
- Public Health or Welfare Agency
- Brooklyn, NY
- NPI 1003075086
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184025600000",
"number": "1487852521",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1623 3RD AVE APT 18F",
"city": "NEW YORK",
"state": "NY",
"postal_code": "101283641",
"telephone_number": "917-374-0009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "425 KINGS HWY",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112231629",
"telephone_number": "718-787-1100"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISCH",
"first_name": "CHARLES",
"name_prefix": "Mr.",
"credential": "M.S.W.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-07-10",
"last_updated": "2007-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "017884-R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02858684",
"state": "NY"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CHARLES",
"last_name": "FISCH",
"prefix": "MR.",
"credential": "MSW",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.