Provider Demographics
NPI:1174189591
Name:VOIGHT-FITZPATRICK, KAITLIN (LICSW)
Entity Type:Individual
Prefix:
First Name:KAITLIN
Middle Name:
Last Name:VOIGHT-FITZPATRICK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:438 DOROTHY DAY PL
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55102-1081
Mailing Address - Country:US
Mailing Address - Phone:651-647-3176
Mailing Address - Fax:
Practice Address - Street 1:438 DOROTHY DAY PL
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55102-1081
Practice Address - Country:US
Practice Address - Phone:651-647-3176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-10
Last Update Date:2019-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty