Provider Demographics
NPI:1841648458
Name:FITZ, EMILY J (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:J
Last Name:FITZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E OGDEN AVE STE 105
Mailing Address - Street 2:PMB 369
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563
Mailing Address - Country:US
Mailing Address - Phone:630-445-1441
Mailing Address - Fax:
Practice Address - Street 1:115 E OGDEN AVE STE 105-369
Practice Address - Street 2:
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-3103
Practice Address - Country:US
Practice Address - Phone:630-445-1441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-25
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490188641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical