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Organization
KIMBERLY FITZGERALD, LICSW INC
Active
Organization
KIMBERLY FITZGERALD, LICSW INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY FITZGERALD LICSW (OWNER & OPERATOR, CLINICAL SOCIAL W)
(508) 364-1182
Entity
Organization
Contact information
Practice address
6 GRANITE STATE CT UNIT 6, BREWSTER, MA 02631-2127
(508) 827-1220
Mailing address
PO BOX 1393, SOUTH YARMOUTH, MA 02664-7393
(508) 364-1182
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000124707
—
MA
05
—
ISW03846
—
RI
Enumeration date
02/20/2024
Last updated
02/20/2024
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