Independent US Healthcare Provider Directory & Public Medical Database Patient Guides

Nicholas Fish , CPSS

Peer Specialist β€’ Longview, WA

Active NPI 1407619158 Individual Practitioner Male Practitioner
Practice location in NPPES

910 16th Ave Ste 120
Longview, WA 986322374

Call 3602005419 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

910 16th Ave Ste 120

Longview, WA 986322374

Telephone 3602005419
Fax 8446126673
Organization at the Same NPPES Address or Phone
Community House On Broadway Facility NPI 1013575588

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Longview, WA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

NPI first issued

2024

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Compared with the same specialty in Longview and Washington

105 active clinicians are listed under Peer Specialist with a practice address in Longview, WA (2,632 in Washington).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Longview

0% of these 105 clinicians have the CMS telehealth indicator.

0% of these 105 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2026-07-30
Peer Specialist Primary Specialty

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES WA PR70090900

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Peer Specialist

NUCC Taxonomy Code: 175T00000X

License # reported to NPPES WA CG61510612

Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Washington State Department of Health Provider Lookup.
Look Up on State Board Site

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid ID
2276550 (WA)

Secondary Practice Locations

1131 Broadway St

Longview, WA 986323830

Phone: 3609983050

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Laura Shellman , PMHNP-BC, FNP-C

Nurse Practitioner - Psychiatric/Mental Health

NPI 1891040812

Psychiatric-Mental Health Nurse Practitioner (Board Certified), Family Nurse Practitioner (Certified)

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

9 Historical Events
πŸ“
Updated Practice Location July 30, 2026

Registered at 910 16TH AVE STE 120, LONGVIEW, WA 986322374 (Tel: 3602005419)

πŸ‘€
Provider Name / Credentials Updated July 30, 2026

Recorded as NICHOLAS FISH, CPSS

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 30, 2026

Peer Specialist (license number reported to NPPES: WA PR70090900)

βœ…
NPI Profile Active February 05, 2024

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) February 05, 2024

Registered at 1131 BROADWAY ST, LONGVIEW, WA 986323830 (Tel: 3609983050)

πŸ“
Business Mailing Address (Initial Record) February 05, 2024

Registered at PO BOX 2394, LONGVIEW, WA 986328455 (Tel: 3602005419)

πŸ‘€
Provider Name / Credentials (Initial Record) February 05, 2024

Recorded as NICHOLAS FISH, R-AAC, CPC

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) February 05, 2024

Peer Specialist (license number reported to NPPES: WA CG61510612)

🟒
Initial NPI Registration & Enumeration February 05, 2024

First registered as active Individual Practitioner in NPPES Database.

No reviews have been published yet. Leave a review.

NPI Administrative Meta

NPI Number: 1407619158
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: February 05, 2024
Last Update: July 30, 2026
Sole Proprietor: No

Mailing Address

Po Box 2394

Longview, WA 986328455

Phone: 3602005419

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.