Active NPI
Debra Berman Fitzgibbons, MSW
- Mental Health Counselor
- Boulder, CO
National Provider Identifier
1639378698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 583039
- Practice address
- 2043 Pearl St
Boulder, CO 80302-4429 - Phone
- (303) 443-0089
- Fax
- (303) 442-2051
- NPI assigned
- Jul 11, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 583039 | CO | Primary |
Addresses
Primary practice location
2043 Pearl St
Boulder, CO 80302-4429
Mailing address
2043 Pearl St
Boulder, CO 80302-4429
Phone (303) 443-0089
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 583039 | CO | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1184112000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1184112000000",
"number": "1639378698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2043 PEARL ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803024429",
"telephone_number": "303-443-0089",
"fax_number": "303-442-2051"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2043 PEARL ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803024429",
"telephone_number": "303-443-0089",
"fax_number": "303-442-2051"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FITZGIBBONS",
"first_name": "DEBRA",
"middle_name": "BERMAN",
"name_prefix": "Ms.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-07-11",
"last_updated": "2007-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CO",
"license": "583039",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.