Provider Demographics
NPI:1124564760
Name:FITZPATRICK, ELIZABETH (LPC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:FITZPATRICK
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 1:600 INTERSTATE PARK DR STE 609
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36109-5474
Mailing Address - Country:US
Mailing Address - Phone:334-676-3520
Mailing Address - Fax:334-676-3521
Practice Address - Street 1:600 INTERSTATE PARK DR STE 609
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36109-5474
Practice Address - Country:US
Practice Address - Phone:334-676-3520
Practice Address - Fax:334-676-3521
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-06
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL3815101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional