Active NPI
Dara Stephanie Fisher, PSYD
- Psychologist
- Philadelphia, PA
National Provider Identifier
1962781922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS017013
- Practice address
- 3400 Civic Center Blvd
2ND Floor, South Pavilion
Philadelphia, PA 19104-5127 - Phone
- (215) 662-3606
- NPI assigned
- Aug 9, 2011
- Last updated
- Aug 6, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS017013 | PA | Primary |
Addresses
Primary practice location
3400 Civic Center Blvd
2ND Floor, South Pavilion
Philadelphia, PA 19104-5127
Mailing address
3400 Civic Center Blvd
2ND Floor, South Pavilion
Philadelphia, PA 19104-5127
Phone (215) 662-3606
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 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1312848000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1438819200000",
"number": "1962781922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"address_2": "2ND FLOOR, SOUTH PAVILION",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "215-662-3606"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3400 CIVIC CENTER BLVD",
"address_2": "2ND FLOOR, SOUTH PAVILION",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "191045127",
"telephone_number": "215-662-3606"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISHER",
"first_name": "DARA",
"middle_name": "STEPHANIE",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-08-09",
"last_updated": "2015-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS017013",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.