Provider Demographics
NPI:1689071540
Name:FITZGERALD, DAISY (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:DAISY
Middle Name:
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:DAISY
Other - Middle Name:
Other - Last Name:GARCIA-FITZGERALD
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW, ADS
Mailing Address - Street 1:3570 E 12TH AVENUE
Mailing Address - Street 2:SUITE 200 BOX#143
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80206
Mailing Address - Country:US
Mailing Address - Phone:720-491-1836
Mailing Address - Fax:
Practice Address - Street 1:3570 E 12TH AVE STE 318C
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-3454
Practice Address - Country:US
Practice Address - Phone:720-491-1836
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-11-20
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCSW.099252531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCSW.09925253OtherDEPARTMENT OF REGULATORY AGENCIES