Active NPI
Cristen Sara Fitzgerald, MA, LPC
- Professional Counselor
- Ridgefield, CT
National Provider Identifier
1215257993
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 004400
- Practice address
- 77 Hunter LN
Ridgefield, CT 06877-4211 - Phone
- (914) 282-1615
- NPI assigned
- Jun 4, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 004400 | CT | Primary |
| Counselor | 101Y00000X |
Addresses
Primary practice location
77 Hunter LN
Ridgefield, CT 06877-4211
Mailing address
77 Hunter LN
Ridgefield, CT 06877-4211
Phone (914) 282-1615
Other practice location 1
112 N Broad St
RM 821
Philadelphia, PA 19102-1512
Phone (215) 568-0860 ext. 3364
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 004400 | CT | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1275609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596067200000",
"number": "1215257993",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 HUNTER LN",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068774211",
"telephone_number": "914-282-1615"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 HUNTER LN",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068774211",
"telephone_number": "914-282-1615"
}
],
"practiceLocations": [
{
"address_1": "112 N Broad St",
"address_2": "RM 821",
"address_purpose": "LOCATION",
"city": "Philadelphia",
"state": "PA",
"postal_code": "191021512",
"country_code": "US",
"telephone_number": "215-568-0860 x3364",
"fax_number": "215-568-0769",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FITZGERALD",
"first_name": "CRISTEN",
"middle_name": "SARA",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-06-04",
"last_updated": "2020-07-30",
"certification_date": "2020-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CT",
"license": "004400",
"primary": true
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Ridgefield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.