Provider Demographics
NPI:1972649325
Name:FRITZ, SHEILA (LCPC)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
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 1:30 S SHUMWAY AVE
Mailing Address - Street 2:STE. #1
Mailing Address - City:BATAVIA
Mailing Address - State:IL
Mailing Address - Zip Code:60510-2499
Mailing Address - Country:US
Mailing Address - Phone:847-683-2522
Mailing Address - Fax:
Practice Address - Street 1:30 S SHUMWAY AVE
Practice Address - Street 2:STE. #1
Practice Address - City:BATAVIA
Practice Address - State:IL
Practice Address - Zip Code:60510-2499
Practice Address - Country:US
Practice Address - Phone:847-683-2522
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4532248OtherBCBS PROVIDER #