Provider Demographics
NPI:1144230715
Name:FRITZ, MEGHAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MEGHAN
Middle Name:
Last Name:FRITZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MEGHAN
Other - Middle Name:
Other - Last Name:LEMERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1315 W COLLEGE AVE
Mailing Address - Street 2:STE 303
Mailing Address - City:STATE COLLEGE
Mailing Address - State:PA
Mailing Address - Zip Code:16801-2776
Mailing Address - Country:US
Mailing Address - Phone:518-307-1990
Mailing Address - Fax:518-307-1990
Practice Address - Street 1:320 ROLLING RIDGE DRIVE, SUITE 100
Practice Address - Street 2:
Practice Address - City:STATE COLLEGE
Practice Address - State:PA
Practice Address - Zip Code:16801
Practice Address - Country:US
Practice Address - Phone:814-867-0670
Practice Address - Fax:814-867-7616
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2020-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY06936411041C0700X
PACW0180551041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02690802Medicaid
IA0715Medicare UPIN
NYIA0715Medicare ID - Type Unspecified