NPIMap

Organization Active NPI

Fitzpatrick Psychological Services

  • Clinical Psychologist
  • Raleigh, NC
National Provider Identifier
1588199764
Registry record updated Jun 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5006 Issued in NC
Legal business name
FITZPATRICK PSYCHOLOGICAL SERVICES
Practice address
111 Windel Drive
Suite 213
Raleigh, NC 27609
Phone
(919) 333-4620
NPI assigned
Apr 26, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2017

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

Authorized official

Name
Elliott Fitzpatrick, PH.D.
Title
Clinical Psychologist
Phone
(919) 333-4620

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TC0700X 5006 NC Primary

Addresses

Primary practice location

111 Windel Drive
Suite 213
Raleigh, NC 27609

Mailing address

111 Windel Drive
Suite 213
Raleigh, NC 27609

National Provider Directory

National Provider Directory

Locations

111 Windel Dr
Ste 213
Raleigh, NC 27609
Phone (919) 333-4620

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1493164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1497312000000",
    "number": "1588199764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 WINDEL DRIVE",
            "address_2": "SUITE 213",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 WINDEL DRIVE",
            "address_2": "SUITE 213",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27609",
            "telephone_number": "919-333-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZPATRICK PSYCHOLOGICAL SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-26",
        "last_updated": "2017-06-13",
        "status": "A",
        "authorized_official_last_name": "FITZPATRICK",
        "authorized_official_first_name": "ELLIOTT",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "919-333-4620",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "5006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2017; 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.