| Kimberly Fitzgerald, Licsw Inc | |
|
6 Granite State Ct Unit 6 Brewster MA 02631-2127 | |
| (508) 827-1220 | |
| Not Available |
| Full Name | Kimberly Fitzgerald, Licsw Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 6 Granite State Ct Unit 6, Brewster, Massachusetts |
| Authorized Official Name and Position | Kimberly Fitzgerald (OWNER & OPERATOR, CLINICAL SOCIAL W) |
| Authorized Official Contact | 5083641182 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kimberly Fitzgerald, Licsw Inc Po Box 1393 South Yarmouth MA 02664-7393 Ph: (508) 364-1182 | Kimberly Fitzgerald, Licsw Inc 6 Granite State Ct Unit 6 Brewster MA 02631-2127 Ph: (508) 827-1220 |
| NPI Number | 1922863877 |
|---|---|
| Provider Enumeration Date | 02/20/2024 |
| Last Update Date | 02/20/2024 |
| Certification Date | 02/20/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922863877 | NPI | - | NPPES |
| 000124707 | Medicaid | MA | |
| ISW03846 | Medicaid | RI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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