Individual provider Active NPI

Eleanor K Fisch, LMSW

  • Behavior Analyst
  • Flushing, NY
National Provider Identifier
1811154479
Registry record updated Aug 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1811154479 Issued in NY
Practice address
14021 31St Rd
Flushing, NY 11354-2157
Phone
(718) 939-1215
NPI assigned
May 21, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0756381 NY
Behavior Analyst 103K00000X 1811154479 NY Primary

Addresses

Primary practice location

14021 31St Rd
Flushing, NY 11354-2157

Mailing address

14021 31St Rd
Flushing, NY 11354-2157
Phone (718) 939-1215

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1811154479NYMDBehavioral Analyst
0756381NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724803200000",
    "number": "1811154479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14021 31ST RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542157",
            "telephone_number": "718-939-1215"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14021 31ST RD",
            "city": "FLUSHING",
            "state": "NY",
            "postal_code": "113542157",
            "telephone_number": "718-939-1215"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISCH",
        "first_name": "ELEANOR",
        "middle_name": "K",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-21",
        "last_updated": "2024-08-28",
        "certification_date": "2024-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0756381",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NY",
            "license": "1811154479",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flushing, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2024; 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.