Provider Demographics
NPI:1912934589
Name:FITZPATRICK-LUCEY, FELICIA BRIGID (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FELICIA
Middle Name:BRIGID
Last Name:FITZPATRICK-LUCEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PLAZA ST E
Mailing Address - Street 2:#5A
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11238-4954
Mailing Address - Country:US
Mailing Address - Phone:718-857-1075
Mailing Address - Fax:
Practice Address - Street 1:2000 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-3521
Practice Address - Country:US
Practice Address - Phone:718-377-5755
Practice Address - Fax:718-377-0752
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053427-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
N6J621Medicare UPIN