Provider Demographics
NPI:1295250314
Name:FITZGERALD, DONNA T (MS, LPC)
Entity type:Individual
Prefix:
First Name:DONNA
Middle Name:T
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4141 B ST STE 301
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-5941
Mailing Address - Country:US
Mailing Address - Phone:907-565-9526
Mailing Address - Fax:907-561-0225
Practice Address - Street 1:4141 B ST STE 301
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-5941
Practice Address - Country:US
Practice Address - Phone:907-565-9526
Practice Address - Fax:907-561-0225
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AKPCOP917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional