Provider Demographics
NPI:1184372823
Name:FRITTS, AMY-NICHOLE (MA, LPC-IT)
Entity type:Individual
Prefix:
First Name:AMY-NICHOLE
Middle Name:
Last Name:FRITTS
Suffix:
Gender:F
Credentials:MA, LPC-IT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4529 ARMISTICE LN
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53704-3209
Mailing Address - Country:US
Mailing Address - Phone:217-316-4901
Mailing Address - Fax:
Practice Address - Street 1:2961 YARMOUTH GREENWAY DR STE 2
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:WI
Practice Address - Zip Code:53711-5809
Practice Address - Country:US
Practice Address - Phone:608-620-5380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2022-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI5249-226101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional