Kelly Ann Fisher, LCSW

Primary specialty

School Social WorkerTaxonomy code 1041S0200X

License

079572 Issued in NY

Practice address

173 Lake Hill Rd
Burnt Hills, NY 12027-9405

Phone

(518) 399-9141

NPI assigned

Oct 26, 2011

Last updated

Mar 16, 2021By 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 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• St. Colman's Home Inc.

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Watervliet, NY
  • NPI 1144351339
  NPD (past)

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

{
    "created_epoch": "1319587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615852800000",
    "number": "1699051326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 AMETHYST DR",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128049498",
            "telephone_number": "518-222-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "173 LAKE HILL RD",
            "city": "BURNT HILLS",
            "state": "NY",
            "postal_code": "120279405",
            "telephone_number": "518-399-9141"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11 Haswell Road",
            "address_purpose": "LOCATION",
            "city": "Watervliet",
            "state": "NY",
            "postal_code": "12189",
            "country_code": "US",
            "telephone_number": "518-273-4911 x212",
            "fax_number": "518-273-3312",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISHER",
        "first_name": "KELLY",
        "middle_name": "ANN",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-26",
        "last_updated": "2021-03-16",
        "certification_date": "2021-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "089977",
            "primary": false
        },
        {
            "code": "1041S0200X",
            "taxonomy_group": "",
            "desc": "Social Worker, School",
            "state": "NY",
            "license": "079572",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisle A Eaton Jr., MD
• Nanette Eddy, LMHC
• Peter W Farrell, DVM
• Elizabeth Susan Farrigan, FNP
• Zachary A Feinberg, M.D.
• Matthew Fisher
• Harold M Flax, FNP
• Richard Fountain, D.M.D.
• Donna Lea Fredericks, RN
• Alicia R Fuss

• School Social Worker in Burnt Hills, NY
• Providers in Burnt Hills, NY by specialty
• School Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.