Individual provider Active NPI

Andrew Howland Fish, LCSW

  • Clinical Social Worker
  • Durham, NC
National Provider Identifier
1629526488
Registry record updated Dec 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C011814 Issued in NC
Practice address
2530 Meridian Pkwy Ste 115
Durham, NC 27713-5273
Phone
(704) 360-3637
NPI assigned
Sep 21, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2025

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 C011814 NC Primary

Addresses

Primary practice location

2530 Meridian Pkwy Ste 115
Durham, NC 27713-5273

Mailing address

2530 Meridian Pkwy Ste 115
Durham, NC 27713-5273
Phone (704) 360-3637

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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

Enrollment IDStateProvider typePAC IDDetails
I20210406000126 NC Practitioner - Clinical Social Worker 0345657581 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
C011814NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Advaita Integrated Medicine PLLC CurrentSince Jan 5, 2026 Accepting new patients

Locations

6124 Saint Giles St
Raleigh, NC 27612
Phone (919) 893-4465

6112 Saint Giles St
Raleigh, NC 27612
Phone (919) 782-3870

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1474416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765929600000",
    "number": "1629526488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2530 MERIDIAN PKWY STE 115",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135273",
            "telephone_number": "704-360-3637"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2530 MERIDIAN PKWY STE 115",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277135273",
            "telephone_number": "704-360-3637"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "ANDREW",
        "middle_name": "HOWLAND",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-21",
        "last_updated": "2025-12-17",
        "certification_date": "2025-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C011814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Durham, NC

Sources for this page

Verify at the official NPI Registry.