Active NPI
Mark Louis Fisher, PH.D.
- Clinical Psychologist
- Severna Park, MD
National Provider Identifier
1659457950
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 2572
- Practice address
- 537 Ritchie Hwy Ste 1C
Severna Park, MD 21146-2930 - Phone
- (410) 315-7715
- Fax
- (410) 315-7541
- NPI assigned
- Oct 29, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 Psychologist | 103TC0700X | 2572 | MD | Primary |
Addresses
Primary practice location
537 Ritchie Hwy Ste 1C
Severna Park, MD 21146-2930
Mailing address
764 Dividing Rd
Severna Park, MD 21146-4324
Phone (410) 544-7352
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2572 | MD | MD | Clinical Psychologist |
| 02572 | MD | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1659457950",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "764 DIVIDING RD",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211464324",
"telephone_number": "410-544-7352"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "537 RITCHIE HWY STE 1C",
"city": "SEVERNA PARK",
"state": "MD",
"postal_code": "211462930",
"telephone_number": "410-315-7715",
"fax_number": "410-315-7541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "MARK",
"middle_name": "LOUIS",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MD",
"license": "2572",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Severna Park, MD
- Ashley K Ferwerda
- Kimberly Ann Fields, D.D.S.
- Leeann L. Fincham, IBCLC
- First Call Medical Center LLC
- Cheryl Yvonne Fisher, MS NCC LGPC
- Five Star Severna Park LLC (Heartlands at Severna Park)
- Elwood Lee Fletcher Jr.
- Kenneth Eugene Fligsten, M.D.
- Forever Fit Physical Therapy & Wellness LLC
- Carol D. Forsyth, C.R.N.P.
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.