Provider Demographics
NPI:1558035725
Name:FITZGERALD, MELISSA CLAIRE (MA, LMFT)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:CLAIRE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:MA, LMFT
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:CLAIRE
Other - Last Name:RUMSEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4526 FEDERAL AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2132
Mailing Address - Country:US
Mailing Address - Phone:425-349-6200
Mailing Address - Fax:
Practice Address - Street 1:1900 D ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-3249
Practice Address - Country:US
Practice Address - Phone:360-389-3468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-02
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X, 101YM0800X
WALF61591849106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health