Terri Fitzgibbon, M SW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2220-123 Issued in WI

Practice address

2515 N 124TH St
Ste 101
Brookfield, WI 53005

Phone

(262) 641-4347

Fax

(262) 641-4350

NPI assigned

Oct 26, 2006

Last updated

Jul 8, 2007By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in WI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 1990

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Shore Counseling and Consulting Clinic SCGroup PAC ID 3072580547, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Shore Counseling and Consulting Clinic, S.C.

  • Group Psychotherapy Psychologist
  • Milwaukee, WI
  • NPI 1588710073
  Medicare reassignment Care Compare group NPD
• Systemic Perspectives, Inc.

  • Mental Health Counselor
  • Elm Grove, WI
  • NPI 1497849152
  Medicare reassignment NPD
• Aurora Psychiatric Hospital, Inc.

  • Psychiatric Hospital
  • Wauwatosa, WI
  • NPI 1881627438
  NPD (past)

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346325495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2515 N 124TH ST",
            "address_2": "STE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-641-4347",
            "fax_number": "262-641-4350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 N 124TH ST",
            "address_2": "STE 101",
            "city": "BROOKFIELD",
            "state": "WI",
            "postal_code": "53005",
            "telephone_number": "262-641-4347",
            "fax_number": "262-641-4350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBON",
        "first_name": "TERRI",
        "credential": "M SW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "2220-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David R Fisher, MD
• Fitness Forward LLC
• Fitness N Mind, LLC
• Fitventures-Pewaukee Inc
• Patrick T Fitzgerald, M.D.
• Five Star Quality Care Wi LLC (Brookfield Rehabilitation and Specialty Care Center)
• Susan L Fleck, O.T.
• Jennifer Flegel, FNP-BC
• Cinthia Fletes
• Katherine Marlen Flores, BS

• Clinical Social Worker in Brookfield, WI
• Providers in Brookfield, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.