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NICOLE PAULINA FISHER MA, LAC
NPI 1194481960
Counselor - Mental Health in Medford, NJ

Active since November 16, 2021Opted out of Medicare · through Jun 14, 2028
66 N MAIN ST, MEDFORD, NJ 08055(609) 714-8400 Get Directions Write a Review

NPPES record last updated: November 16, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Nicole Paulina Fisher Ma, Lac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

NICOLE PAULINA FISHER MA, LAC (NPI 1194481960) is an individual mental health provider in Medford, New Jersey, licensed in New Jersey (37AC00611800) and active in the NPI registry since November 2021. She has opted out of Medicare through June 14, 2028.

NPPES Registry Identity

NPI1194481960
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameNICOLE PAULINA FISHERCredential: MA, LAC
Location Address66 N MAIN STMedford, NJ 08055-2719
Mailing Address66 N Main StMedford, NJ 08055-2719 · (609) 714-8400
Phone(609) 714-8400
Sole ProprietorNo
Enumeration DateNovember 16, 2021
NPPES CertifiedNovember 16, 2021
✔ NPI 1194481960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NJ · 37AC00611800
66 N MAIN ST, Medford, NJ 08055
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Nicole Paulina Fisher Ma, Lac has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from June 14, 2024 through June 14, 2028.

Opt-Out Effective DateJune 14, 2024
Opt-Out In Effect ThroughJune 14, 2028Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLISON BEATRIZ GONZALEZ MSW,LCSW
Social Worker (Clinical)
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (973) 997-8545
JULIA MANNINO
Counselor
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (856) 714-8400
MS. JEANNE MARIE BAUER M.A., L.P.C.
Counselor (Professional)
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (856) 985-9091
MRS. DAWN P CAPPELLO LAC
Counselor
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (609) 714-8400
MS. SUSAN CLARK MIA, MS, LAC
Counselor (Mental Health)
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (609) 714-8400
CATHERINE LEDERMAN
Counselor (Professional)
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (856) 985-9091
MS. TEMIMA ROTHMEL LCSW
Social Worker (Clinical)
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (856) 362-4001
MS. ALLISON SCHOENEWALD LCSW
Social Worker (Clinical)
66 N MAIN ST
MEDFORD, NJ 08055
Burlington County (609) 714-8400

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nicole Fisher's NPI number?

The NPI number for Nicole Fisher is 1194481960. It was assigned to this individual provider in the NPPES registry on November 16, 2021.

Where is Nicole Fisher located?

Nicole Fisher practices at 66 N Main St, Medford, NJ 08055. The listed phone number is (609) 714-8400.

What is Nicole Fisher's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Nicole Fisher enrolled in Medicare?

No. Nicole Fisher has opted out of Medicare through June 14, 2028. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Nicole Fisher was last updated on November 16, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.