Active NPI
Colleen Fitzgerald
- Professional Counselor
- Washington, DC
National Provider Identifier
1083146625
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LGPC00087
- Practice address
- 2639 Connecticut Ave NW
Suite 251
Washington, DC 20008-1537 - Phone
- (202) 681-4374
- NPI assigned
- Apr 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LGPC00087 | DC | Primary |
| Professional Counselor | 101YP2500X | LGP6561 | MD |
Addresses
Primary practice location
2639 Connecticut Ave NW
Suite 251
Washington, DC 20008-1537
Mailing address
5102 Flanders Ave
Kensington, MD 20895-1135
Phone (202) 641-8113
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 10, 2024 through Apr 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LGPC00087 | DC | MD | Professional Counselor |
| LGP6561 | MD | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1491091200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491091200000",
"number": "1083146625",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5102 FLANDERS AVE",
"city": "KENSINGTON",
"state": "MD",
"postal_code": "208951135",
"telephone_number": "202-641-8113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2639 CONNECTICUT AVE NW",
"address_2": "SUITE 251",
"city": "WASHINGTON",
"state": "DC",
"postal_code": "200081537",
"telephone_number": "202-681-4374"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGERALD",
"first_name": "COLLEEN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-04-02",
"last_updated": "2017-04-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DC",
"license": "LGPC00087",
"primary": true
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LGP6561",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Washington, DC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.