Provider Demographics
NPI:1073783957
Name:FITZSIMMONS, CHRISTINA MARIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:CHRISTINA
Middle Name:MARIA
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 1:1450 PALISADE AVE
Mailing Address - Street 2:APT. 1-I
Mailing Address - City:FORT LEE
Mailing Address - State:NJ
Mailing Address - Zip Code:07024-5212
Mailing Address - Country:US
Mailing Address - Phone:201-917-5369
Mailing Address - Fax:
Practice Address - Street 1:20 WILSEY SQ
Practice Address - Street 2:SUITE C
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-3793
Practice Address - Country:US
Practice Address - Phone:201-445-1068
Practice Address - Fax:201-445-7995
Is Sole Proprietor?:No
Enumeration Date:2008-03-06
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052775001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical