Deborah A Fisk, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

003080 Issued in CT

Practice address

34 Park St
Connecticut Mental Health Center
New Haven, CT 06519

Phone

(203) 974-7417

Fax

(203) 974-7413

NPI assigned

Nov 27, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• State of Connecticut

  dba Connecticut Mental Health Center

  • Psychiatric Hospital
  • New Haven, CT
  • NPI 1881629434
  Medicare reassignment NPD
• State of Connecticut

  dba Department of Veterans' Affairs, Veterans Home

  • Skilled Nursing Facility
  • Rocky Hill, CT
  • NPI 1205951662
  NPD

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1619043122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "address_2": "OFFICE OF CARE MANGEMENT",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-974-7417",
            "fax_number": "203-974-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34 PARK ST",
            "address_2": "CONNECTICUT MENTAL HEALTH CENTER",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "06519",
            "telephone_number": "203-974-7417",
            "fax_number": "203-974-7413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISK",
        "first_name": "DEBORAH",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "003080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Benjamin Ronald Fisher
• Clark Andrew Fisher, MD, PHD
• Jessica Fisher
• Rosemarie Louise Fisher, MD
• Emily Fishman
• Jonathan Fisk, DMD
• David Loring Fitter
• Holly A Fitting, LCMHC LCDP
• Susan Denise Fitzgerald Ely, MD, MPHTM
• Joseph Murray Fitzgerald Jr., LCSW

• Clinical Social Worker in New Haven, CT
• Providers in New Haven, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.