=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891230660
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | NATHALIE JOYCE FISCHER-RODRIGUEZ LICSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/03/2017
-----------------------------------------------------
Last Update Date | 09/01/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8 TRUMBULL RD STE 201
-----------------------------------------------------
City | NORTHAMPTON
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01060-3080
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-341-0194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 27 S MAIN ST
-----------------------------------------------------
City | HAYDENVILLE
-----------------------------------------------------
State | MA
-----------------------------------------------------
Zip | 01039-9738
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 413-341-0194
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 122171
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------