Basic Information
| Provider Information | |||||||||
| NPI: | 1235185570 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | MICHAEL | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | M.S.W. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 176 W 87TH ST | ||||||||
| Address2: | APT. 7A | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100242902 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2127249459 | ||||||||
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| Practice Location | |||||||||
| Address1: | 423 E 23RD ST | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100105011 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126867500 | ||||||||
| FaxNumber: | 2129513391 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 070991-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.