Provider Demographics
NPI:1841555059
Name:FITZPATRICK, NOELLE (LPC)
Entity type:Individual
Prefix:MRS
First Name:NOELLE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7547 MENTOR AVE
Mailing Address - Street 2:SUITE 310
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5438
Mailing Address - Country:US
Mailing Address - Phone:216-280-8480
Mailing Address - Fax:
Practice Address - Street 1:7547 MENTOR AVE
Practice Address - Street 2:SUITE 310
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5438
Practice Address - Country:US
Practice Address - Phone:216-280-8480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-07-13
Last Update Date:2016-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.1100121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268768Medicaid