Mary Fitzgibbons, PH.D

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

00944 Issued in MO

Practice address

12125 Woodcrest Executive Dr
Saint Louis, MO 63141-5001

Phone

(314) 275-8599

NPI assigned

Oct 29, 2007

Sex

Female

Sole proprietor

Yes

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 MO

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 Psychologist

Education

Other, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Madmar LLCGroup PAC ID 8628516119, 9 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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 and National Provider Directory roles.

• Madmar, LLC

  • Counselor
  • Saint Louis, MO
  • NPI 1053152892
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1193616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193702400000",
    "number": "1679752562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415001",
            "telephone_number": "314-275-8599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12125 WOODCREST EXECUTIVE DR",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631415001",
            "telephone_number": "314-275-8599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBONS",
        "first_name": "MARY",
        "credential": "PH.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-29",
        "last_updated": "2007-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "MO",
            "license": "00944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Regina Fitzgerald
• Thomas Paul Fitzgerald
• Wilson Fitzgerald
• Fitzgibbons Psychological West County Psychological Associates
• Haley Danielle Fitzgibbons, MSW, LCSW
• Sean C Fitzmaurice, MD
• Brendan Michael Fitzpatrick, M.D.
• Brittany Nicole Fitzpatrick, MD
• Colleen M. Fitzpatrick, MD
• Ellen E. Fitzsimmons-Craft, PHD, LP

• Counseling Psychologist in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Counseling Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 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.