Provider Demographics
NPI:1093297616
Name:FITZGERALD COUNSELING GROUP
Entity Type:Organization
Organization Name:FITZGERALD COUNSELING GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:FITZGERALD
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:978-408-6446
Mailing Address - Street 1:21 FATHER DEVALLES BLVD STE 15
Mailing Address - Street 2:
Mailing Address - City:FALL RIVER
Mailing Address - State:MA
Mailing Address - Zip Code:02723-1519
Mailing Address - Country:US
Mailing Address - Phone:978-408-6446
Mailing Address - Fax:
Practice Address - Street 1:21 FATHER DEVALLES BLVD STE 15
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02723-1519
Practice Address - Country:US
Practice Address - Phone:978-408-6446
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty