Provider Demographics
NPI:1841568375
Name:FRITZ, AMIE ELIZABETH (LCPC)
Entity Type:Individual
Prefix:MRS
First Name:AMIE
Middle Name:ELIZABETH
Last Name:FRITZ
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 1:18161 MORRIS AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:HOMEWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60430-2141
Mailing Address - Country:US
Mailing Address - Phone:708-957-3303
Mailing Address - Fax:
Practice Address - Street 1:18161 MORRIS AVE STE 204
Practice Address - Street 2:
Practice Address - City:HOMEWOOD
Practice Address - State:IL
Practice Address - Zip Code:60430-2141
Practice Address - Country:US
Practice Address - Phone:708-957-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-12
Last Update Date:2011-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.008041101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor