Provider Demographics
NPI:1851328728
Name:FITTING, HOLLY A (LCMHC LCDP)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:A
Last Name:FITTING
Suffix:
Gender:F
Credentials:LCMHC LCDP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 WOBURN AVE
Mailing Address - Street 2:
Mailing Address - City:BRISTOL
Mailing Address - State:RI
Mailing Address - Zip Code:02809
Mailing Address - Country:US
Mailing Address - Phone:401-529-1523
Mailing Address - Fax:
Practice Address - Street 1:50 FITCH ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-1366
Practice Address - Country:US
Practice Address - Phone:203-361-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X
RILCDP307101YA0400X
RIMHC120101YM0800X
CT5956101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI300988OtherBLUE CROSS
RI407828OtherBLUE CHIP
RIHF30111Medicaid
6294210OtherUBH