Provider Demographics
NPI:1437306966
Name:FUGATT, CYNTHIA FRITZ (LCSW)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:FRITZ
Last Name:FUGATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 MEADOW TOP LN
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37931-1632
Mailing Address - Country:US
Mailing Address - Phone:865-384-3660
Mailing Address - Fax:
Practice Address - Street 1:11808 KINGSTON PIKE
Practice Address - Street 2:SUITE 100
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-3803
Practice Address - Country:US
Practice Address - Phone:865-392-5753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN00000042131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical