Mary W Fitzgerald, LCSW, CAC III

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

991899 Issued in CO

Practice address

5540 Tech Center Dr
Springs Counseling Center, #203
Colorado Springs, CO 80919-2331

Phone

(719) 548-0100

Fax

(719) 548-0616

NPI assigned

Oct 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other names 1

• Kim W Fitzgerald Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Springs Counseling Center

  • Mental Health Counselor
  • Colorado Springs, CO
  • NPI 1003943150
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1263945600000",
    "number": "1114001971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1349 LINDENROSE GROVE",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "80907",
            "telephone_number": "719-548-0100",
            "fax_number": "719-548-0616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5540 TECH CENTER DR",
            "address_2": "SPRINGS COUNSELING CENTER, #203",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809192331",
            "telephone_number": "719-548-0100",
            "fax_number": "719-548-0616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MARY",
        "middle_name": "W",
        "credential": "LCSW, CAC III",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-25",
        "last_updated": "2010-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "991899",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KIM",
            "last_name": "FITZGERALD",
            "middle_name": "W",
            "credential": "LCSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Amy Fitzgerald, NP
• Bianca Fitzgerald
• Ceana Kylie Oluwakemi Fitzgerald
• Kellee Fitzgerald, CRNA
• Lillian Lee Fitzgerald
• Maryanne Fitzgerald, ATC
• Brian Douglas Fitzpatrick, D.M.D.
• Cheryl Elizabeth Fitzsimmons, M.A.
• Fitzwater Chiropractic Clinic PC
• Five Star Quality Care-Colorado LLC

• Clinical Social Worker in Colorado Springs, CO
• Providers in Colorado Springs, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.