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Individual

MRS. ANN BERGAN FITZGERALD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LICSW

Contact information

Practice address
10 CABOT RD FL 1, MEDFORD, MA 02155-5177
(781) 393-5152
(781) 393-5168
Mailing address
173 CHELSEA ST, EVERETT, MA 02149
(781) 861-0890

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
110624
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
12515715
MULTI-PLAN
MA
01
1518164508
FALLON COMMUNITY HEALTH PLAN
MA
01
1538222716
UBH
MA
01
486325
VALUE OPTIONS
MA
01
9186232
PHCS
MA
01
987309-02
NETWORK HEALTH
MA
Enumeration date
12/18/2006
Last updated
11/20/2015
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