Provider Demographics
NPI:1528593027
Name:FITZMAURICE, MAUREEN L (NCC, LCPC)
Entity Type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:L
Last Name:FITZMAURICE
Suffix:
Gender:F
Credentials:NCC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N VINE ST UNIT 201
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1652
Mailing Address - Country:US
Mailing Address - Phone:815-641-6934
Mailing Address - Fax:
Practice Address - Street 1:305 N VINE ST UNIT 201
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1652
Practice Address - Country:US
Practice Address - Phone:815-320-3749
Practice Address - Fax:815-320-3825
Is Sole Proprietor?:No
Enumeration Date:2017-04-22
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X
IL180.014518101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional