Provider Demographics
NPI:1770665549
Name:FITZGERALD, LINDA C (MSW)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:C
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17104-1677
Mailing Address - Country:US
Mailing Address - Phone:717-231-8539
Mailing Address - Fax:717-231-8588
Practice Address - Street 1:205 S FRONT ST
Practice Address - Street 2:5THFLOOR
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17104-1619
Practice Address - Country:US
Practice Address - Phone:717-231-8360
Practice Address - Fax:717-231-8358
Is Sole Proprietor?:No
Enumeration Date:2006-10-20
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW123294104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA50065383OtherBLUE CROSS/CAIC
PASW123294OtherSOCIAL WORKER LICENSE