Provider Demographics
NPI:1609334838
Name:FITZPATRICK, JESSICA (LCPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5977 JEFFERSON COMMONS WAY
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21703-2946
Mailing Address - Country:US
Mailing Address - Phone:813-476-5200
Mailing Address - Fax:
Practice Address - Street 1:131 W PATRICK ST
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-5683
Practice Address - Country:US
Practice Address - Phone:813-476-5200
Practice Address - Fax:301-732-6916
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC10514101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health