Active NPI
Susan Jean Fitz-Patrick, M.S.
- Marriage & Family Therapist
- Corvallis, OR
National Provider Identifier
1063608297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- T0545
- Practice address
- 508 SW Jefferson Ave
Corvallis, OR 97333-4603 - Phone
- (541) 207-6267
- NPI assigned
- Sep 20, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | T0545 | OR | Primary |
Addresses
Primary practice location
508 SW Jefferson Ave
Corvallis, OR 97333-4603
Mailing address
5541 SW Bluestem PL
Corvallis, OR 97333-1354
Phone (541) 207-6267
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| T0545 | OR | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1190246400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1190246400000",
"number": "1063608297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5541 SW BLUESTEM PL",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973331354",
"telephone_number": "541-207-6267"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "508 SW JEFFERSON AVE",
"city": "CORVALLIS",
"state": "OR",
"postal_code": "973334603",
"telephone_number": "541-207-6267"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZ-PATRICK",
"first_name": "SUSAN",
"middle_name": "JEAN",
"name_prefix": "Mrs.",
"credential": "M.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-09-20",
"last_updated": "2007-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "OR",
"license": "T0545",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Corvallis, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.