Provider Demographics
NPI:1053855197
Name:FITZGERALD, SLOANE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SLOANE
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1547 REYNOLDS DR
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:AL
Mailing Address - Zip Code:36830-1932
Mailing Address - Country:US
Mailing Address - Phone:334-332-7332
Mailing Address - Fax:
Practice Address - Street 1:1547 REYNOLDS DR
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:AL
Practice Address - Zip Code:36830-1932
Practice Address - Country:US
Practice Address - Phone:334-332-7332
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-08
Last Update Date:2016-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3623101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor