Provider Demographics
NPI:1740678424
Name:FITZGERALD, SHEA MARIE (LMHC, LMFTA, SUDP)
Entity type:Individual
Prefix:
First Name:SHEA
Middle Name:MARIE
Last Name:FITZGERALD
Suffix:
Gender:
Credentials:LMHC, LMFTA, SUDP
Other - Prefix:
Other - First Name:SHEA
Other - Middle Name:MARIE
Other - Last Name:SCHEULER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, LMFTA, SUDP
Mailing Address - Street 1:2737 SIENNA DR SE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98501-5814
Mailing Address - Country:US
Mailing Address - Phone:206-580-3285
Mailing Address - Fax:
Practice Address - Street 1:2737 SIENNA DR SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-5814
Practice Address - Country:US
Practice Address - Phone:206-580-3285
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-02
Last Update Date:2025-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH61587141101YM0800X
WACO 60270827101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WACO 60270827OtherWASHINGTON STATE DEPARTMENT OF HEALTH