Individual provider Active NPI

Nancy Carol Fish, LCSW

  • Mental Health Counselor
  • Fair Lawn, NJ
National Provider Identifier
1861554388
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
44SC04902200 Issued in NJ
Practice address
4-61 Ivy LN
Fair Lawn, NJ 07410-1652
Phone
(201) 796-8544
Fax
(201) 796-3541
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 44SC04902200 NJ Primary

Addresses

Primary practice location

4-61 Ivy LN
Fair Lawn, NJ 07410-1652

Mailing address

4-61 Ivy LN
Fair Lawn, NJ 07410-1652
Phone (201) 796-8544

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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
I20171227000106 NJ Practitioner - Clinical Social Worker 8022376946 Practice locations: Fair Lawn, NJ

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1984
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4 -61 Ivy LN
Fair Lawn, NJ 07410-1652
Phone (201) 791-4321

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC04902200NJMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1861554388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4-61 IVY LN",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101652",
            "telephone_number": "201-796-8544",
            "fax_number": "201-796-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4-61 IVY LN",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074101652",
            "telephone_number": "201-796-8544",
            "fax_number": "201-796-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISH",
        "first_name": "NANCY",
        "middle_name": "CAROL",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NJ",
            "license": "44SC04902200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

Verify at the official NPI Registry.