Clarence Fiedler – School Psychologist

Key facts

NPI: 1891839619
Entity type: Individual (NPI type 1)
Primary specialty: School Psychologist 103TS0200X
License: 4169 (DE)
Practice address: 31 Hosier St
Selbyville, DE 19975-9300
Phone: (302) 436-1000
NPI assigned: Feb 16, 2007
Sex: Male
Sole proprietor: No

Organizations & group practices 1

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.

State of Delaware Local Education Agency (LEA) · Selbyville, DE · NPI 1659415529

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
4169	DE	MD	School Psychologist

Practice roles

Organization	Specialty	Status	New patients
State of Delaware		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
School Psychologist	103TS0200X	4169	DE	Yes

Addresses

Primary practice location

31 Hosier St
Selbyville, DE 19975-9300

Mailing address

31 Hosier St
Selbyville, DE 19975-9300

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 8, 2007.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891839619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 HOSIER ST",
            "city": "SELBYVILLE",
            "state": "DE",
            "postal_code": "199759300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31 HOSIER ST",
            "city": "SELBYVILLE",
            "state": "DE",
            "postal_code": "199759300",
            "telephone_number": "302-436-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIEDLER",
        "first_name": "CLARENCE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "DE",
            "license": "4169",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Selbyville, DE

All providers in Selbyville, DE · School Psychologist in Delaware

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.