Provider Demographics
NPI:1891230660
Name:FISCHER-RODRIGUEZ, NATHALIE JOYCE (LICSW)
Entity Type:Individual
Prefix:
First Name:NATHALIE
Middle Name:JOYCE
Last Name:FISCHER-RODRIGUEZ
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HAYDENVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:01039-9738
Mailing Address - Country:US
Mailing Address - Phone:413-341-0194
Mailing Address - Fax:
Practice Address - Street 1:8 TRUMBULL RD
Practice Address - Street 2:STE 201
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3080
Practice Address - Country:US
Practice Address - Phone:413-341-0194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-03
Last Update Date:2020-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1221711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical