Active NPI
Alene W. Fisk, PHD
- Clinical Psychologist
- Davidson, NC
National Provider Identifier
1972801538
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 3387
- Practice address
- 709 Northeast Dr
Suite 19
Davidson, NC 28036-7430 - Phone
- (704) 661-9346
- NPI assigned
- Mar 7, 2011
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3387 | NC | Primary |
Addresses
Primary practice location
709 Northeast Dr
Suite 19
Davidson, NC 28036-7430
Mailing address
709 Northeast Dr
Suite 19
Davidson, NC 28036-7430
Phone (704) 661-9346
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3387 | NC | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1299456000000",
"number": "1972801538",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 NORTHEAST DR",
"address_2": "SUITE 19",
"city": "DAVIDSON",
"state": "NC",
"postal_code": "280367430",
"telephone_number": "704-661-9346"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "709 NORTHEAST DR",
"address_2": "SUITE 19",
"city": "DAVIDSON",
"state": "NC",
"postal_code": "280367430",
"telephone_number": "704-661-9346"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISK",
"first_name": "ALENE",
"middle_name": "W.",
"name_prefix": "Dr.",
"credential": "PHD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-07",
"last_updated": "2011-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NC",
"license": "3387",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davidson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.