Provider Demographics
NPI:1225556301
Name:FITZSIMMONS, MAGGIE L (LMHC)
Entity Type:Individual
Prefix:
First Name:MAGGIE
Middle Name:L
Last Name:FITZSIMMONS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5237
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-5237
Mailing Address - Country:US
Mailing Address - Phone:315-402-5866
Mailing Address - Fax:
Practice Address - Street 1:106 W UTICA ST STE E
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-3059
Practice Address - Country:US
Practice Address - Phone:315-741-5866
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-08
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health