Provider Demographics
NPI:1235737453
Name:PIERRE, FITZGERALD (MSW)
Entity Type:Individual
Prefix:MR
First Name:FITZGERALD
Middle Name:
Last Name:PIERRE
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4313 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:ROSLINDALE
Mailing Address - State:MA
Mailing Address - Zip Code:02131-3002
Mailing Address - Country:US
Mailing Address - Phone:617-504-0151
Mailing Address - Fax:
Practice Address - Street 1:4313 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:ROSLINDALE
Practice Address - State:MA
Practice Address - Zip Code:02131-3002
Practice Address - Country:US
Practice Address - Phone:617-504-0151
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health