Provider Demographics
NPI:1073067658
Name:FITZSIMMONS, AMY KATHRYN L (LCSW)
Entity Type:Individual
Prefix:
First Name:AMY KATHRYN
Middle Name:L
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 W 2ND ST
Mailing Address - Street 2:
Mailing Address - City:MOORESTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08057-2457
Mailing Address - Country:US
Mailing Address - Phone:856-296-1482
Mailing Address - Fax:
Practice Address - Street 1:33 W 2ND ST
Practice Address - Street 2:
Practice Address - City:MOORESTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08057-2457
Practice Address - Country:US
Practice Address - Phone:856-296-1482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-11
Last Update Date:2020-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056621001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical