Provider Demographics
NPI:1376315853
Name:FRITZ, JOLIE D (LPC)
Entity Type:Individual
Prefix:
First Name:JOLIE
Middle Name:D
Last Name:FRITZ
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:JOLIE
Other - Middle Name:D
Other - Last Name:RICHARDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:W243N2358 SADDLE BROOK DR APT 204
Mailing Address - Street 2:
Mailing Address - City:PEWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53072-6402
Mailing Address - Country:US
Mailing Address - Phone:262-893-5391
Mailing Address - Fax:
Practice Address - Street 1:W243N2358 SADDLE BROOK DR APT 204
Practice Address - Street 2:
Practice Address - City:PEWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53072-6402
Practice Address - Country:US
Practice Address - Phone:262-893-5391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-26
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7350-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional