Nathaniel Fisher, LICDC, LPC

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

161551 Issued in OH

Practice address

5726 Southwyck Blvd
Toledo, OH 43614-1559

Phone

(419) 865-5690

NPI assigned

Apr 30, 2018

Last updated

Jun 16, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1525046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529107200000",
    "number": "1881182434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "839 CLOVERDALE RD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436123111",
            "telephone_number": "419-870-2104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5726 SOUTHWYCK BLVD",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436141559",
            "telephone_number": "419-865-5690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FISHER",
        "first_name": "NATHANIEL",
        "credential": "LICDC, LPC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-04-30",
        "last_updated": "2018-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "161551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1487088209",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Andrea Fisher
• Casey Sunovia Fisher
• Emily Fisher, FNP-BC
• Leah Fisher, LSW
• Mickey Fisher
• Robert Joseph Fisher, PHYSICIAN ASSISTANT
• Sharon K. Fisher, QMHS
• Shavonda Fisher
• Tara Fisher
• Victoria Fisher, L.P.N.

• Addiction (Substance Use Disorder) Psychologist in Toledo, OH
• Providers in Toledo, OH by specialty
• Addiction (Substance Use Disorder) Psychologist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 2018; 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.