Healthcare Provider Details

I. General information

NPI: 1295673119
Provider Name (Legal Business Name): MATTHEW FISHER LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2026
Last Update Date: 03/23/2026
Certification Date: 03/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

58 HIGH ST
TORRINGTON CT
06790-5106
US

IV. Provider business mailing address

969 W MAIN ST STE 3A
WATERBURY CT
06708-2653
US

V. Phone/Fax

Practice location:
  • Phone: 860-496-2100
  • Fax:
Mailing address:
  • Phone: 860-496-2100
  • Fax: 860-496-2111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number16465
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: