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Individual
MARY F FITZPATRICK
Active
Individual
MARY F FITZPATRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCPC, LAC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1011
MT
101YM0800X
Mental Health Counselor
Primary
976
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0216121
—
MT
01
—
760510
BLUE CROSS BLUE SHIELD
MT
Enumeration date
09/27/2005
Last updated
02/11/2009
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