Provider Demographics
NPI:1689797011
Name:FITZGERALD, REBECCA ANN (LPC)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:ANN
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 MORRISS RD
Mailing Address - Street 2:BUILDING II, SUITE 109A
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-3710
Mailing Address - Country:US
Mailing Address - Phone:214-649-0932
Mailing Address - Fax:
Practice Address - Street 1:6021 MORRISS RD
Practice Address - Street 2:BUILDING II, SUITE 109A
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-3710
Practice Address - Country:US
Practice Address - Phone:214-649-0932
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX15199101YP2500X
TX46890101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional