Individual provider Active NPI

Nadine Renee Fish, MSW

  • Social Worker
  • Benton Harbor, MI
National Provider Identifier
1790097640
Registry record updated Jul 8, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
6801090473 Issued in MI
Practice address
1485 M 139
Benton Harbor, MI 49022-5711
Phone
(269) 925-0585
Fax
(269) 927-1326
NPI assigned
Jul 8, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 6801090473 MI Primary

Addresses

Primary practice location

1485 M 139
Benton Harbor, MI 49022-5711

Mailing address

1485 M 139
Benton Harbor, MI 49022-5711
Phone (269) 925-0585

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20110228000345 MI Practitioner - Clinical Social Worker 8022299817 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Berrien Mental Health AuthorityGroup PAC ID 0345223707, 20 clinicians

Practice addresses (Care Compare)

1485 M
Suite 139
Benton Harbor, MI 49022-5711
Phone (269) 934-1611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Berrien Mental Health Authority Social Worker CurrentSince Jun 5, 2012 Accepting new patients
Hope Reborn Counseling, PLLC Current Accepting new patients
Nadine Fish Inc Current Accepting new patients
Berrien Mental Health Authority CurrentSince Jun 5, 2012 Accepting new patients

Locations

1485 M 139
Benton Harbor, MI 49022
Phone (269) 934-1611

3950 Hollywood Rd
Ste 245
Saint Joseph, MI 49085
Phone (269) 982-7844

2500 Niles Rd
Ste 7
Saint Joseph, MI 49085
Phone (269) 281-0407

Organizations & group practices 4

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": "1278547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278547200000",
    "number": "1790097640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225711",
            "telephone_number": "269-925-0585",
            "fax_number": "269-927-1326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 M 139",
            "city": "BENTON HARBOR",
            "state": "MI",
            "postal_code": "490225711",
            "telephone_number": "269-925-0585",
            "fax_number": "269-927-1326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "NADINE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-08",
        "last_updated": "2010-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801090473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Benton Harbor, MI

Sources for this page

Verify at the official NPI Registry.