Provider Demographics
NPI:1538138359
Name:FITZGERALD, HELEN J (LMFT)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:J
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:VELLUCCI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NH
Mailing Address - Zip Code:03301
Mailing Address - Country:US
Mailing Address - Phone:603-226-1999
Mailing Address - Fax:603-224-1675
Practice Address - Street 1:33 WARREN ST
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NH
Practice Address - Zip Code:03301
Practice Address - Country:US
Practice Address - Phone:603-226-1999
Practice Address - Fax:603-224-1675
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH4106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30006688Medicaid