Kelsey Fisher, LCSW
Individual provider Active NPI Clinical Social Worker · Portland, ME
NPI 1942979190 · NPPES record last updated Sep 10, 2021
Key facts
- NPI
- 1942979190
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- LC20560 (ME)
- Practice address
- 132 Marginal Way Apt 356
Portland, ME 04101-7420 - Phone
- (949) 584-9808
- NPI assigned
- Sep 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| LC20560 | ME | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | LC20560 | ME | Yes |
Addresses
Primary practice location
132 Marginal Way Apt 356
Portland, ME 04101-7420
Mailing address
132 Marginal Way Apt 356
Portland, ME 04101-7420
Phone (949) 584-9808
NPI Registry JSON
{
"created_epoch": "1631232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1631232000000",
"number": "1942979190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "132 MARGINAL WAY APT 356",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041017420",
"telephone_number": "949-584-9808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "132 MARGINAL WAY APT 356",
"city": "PORTLAND",
"state": "ME",
"postal_code": "041017420",
"telephone_number": "949-584-9808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "KELSEY",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-09-10",
"last_updated": "2021-09-10",
"certification_date": "2021-09-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "ME",
"license": "LC20560",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
- Avital Fischer
- Dawn Fischer
- Gregory John Fisher
- Jennifer H Fisher
- Karen Dubbs Fisher
- Patrick William Fisher
- Shelly Dawn Fisher
- Stacia Fitch
- Lashawna Marie Fitts
- Hayley Gabrielle Fitzgerald
All providers in Portland, ME · Clinical Social Worker in Maine
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 10, 2021. 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.