Active NPI
Daniel Philip Fishman, PHD
- Clinical Psychologist
- Brookline, MA
National Provider Identifier
1851619563
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 9792
- Practice address
- 233 Harvard St
Suite 207
Brookline, MA 02446-5069 - Phone
- (617) 429-6414
- NPI assigned
- May 6, 2010
- 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 | 9792 | MA | Primary |
Addresses
Primary practice location
233 Harvard St
Suite 207
Brookline, MA 02446-5069
Mailing address
233 Harvard St
Suite 207
Brookline, MA 02446-5069
Phone (617) 429-6414
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 24, 2023 through Apr 24, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9792 | MA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273104000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1424217600000",
"number": "1851619563",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "233 HARVARD ST",
"address_2": "SUITE 207",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465069",
"telephone_number": "617-429-6414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "233 HARVARD ST",
"address_2": "SUITE 207",
"city": "BROOKLINE",
"state": "MA",
"postal_code": "024465069",
"telephone_number": "617-429-6414"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHMAN",
"first_name": "DANIEL",
"middle_name": "PHILIP",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-05-06",
"last_updated": "2015-02-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MA",
"license": "9792",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookline, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.