Provider Demographics
NPI:1841464559
Name:FITTS, PETER STANLEY (MSW)
Entity type:Individual
Prefix:
First Name:PETER
Middle Name:STANLEY
Last Name:FITTS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7413 QUAIL RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-4350
Mailing Address - Country:US
Mailing Address - Phone:301-518-1659
Mailing Address - Fax:
Practice Address - Street 1:9821 GREENBELT RD STE 208
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-2269
Practice Address - Country:US
Practice Address - Phone:301-518-1659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD069071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical