Kris Fitzgerald, LMHC, PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 13651 Issued in FL

Legal business name

KRIS FITZGERALD, LMHC, PLLC

Practice address

116 Brookshire Dr
Lake Wales, FL 33898-7601

Phone

(863) 241-2785

NPI assigned

Mar 29, 2016

Organization subpart

No

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

Authorized official

Name

Kristen T Fitzgerald, LMHC

Title

Licensed Mental Health Counselor

Phone

(863) 241-2785

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1459209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1459209600000",
    "number": "1205299161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3657",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338593657",
            "telephone_number": "863-241-2785"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 BROOKSHIRE DR",
            "city": "LAKE WALES",
            "state": "FL",
            "postal_code": "338987601",
            "telephone_number": "863-241-2785"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KRIS FITZGERALD, LMHC, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-03-29",
        "last_updated": "2016-03-29",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "LICENSED MENTAL HEALTH COUNSELOR",
        "authorized_official_telephone_number": "863-241-2785",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 13651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mental Health Counselor in Lake Wales, FL
• Providers in Lake Wales, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2016; 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.