NPIMap

Organization Active NPI

Fitzgerald Psychological Services, P.S.

  • Psychologist
  • Clarkston, WA
National Provider Identifier
1710322755
Registry record updated May 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Legal business name
FITZGERALD PSYCHOLOGICAL SERVICES, P.S.
Practice address
629 6TH St
Clarkston, WA 99403-2010
Phone
(509) 758-9698
Fax
(509) 758-9664
NPI assigned
May 3, 2013
Last updated
May 3, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 3, 2013

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

Authorized official

Name
Dr. Jarod John Fitzgerald, PH.D.NPI 1477690576
Title
Licensed Psychologist
Phone
(509) 758-9698

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103T00000X Primary

Addresses

Primary practice location

629 6TH St
Clarkston, WA 99403-2010

Mailing address

629 6TH St
Clarkston, WA 99403-2010
Phone (509) 758-9698

National Provider Directory

National Provider Directory

Locations

629 6th St
Clarkston, WA 99403
Phone (509) 758-9698

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1367539200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367539200000",
    "number": "1710322755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 6TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032010",
            "telephone_number": "509-758-9698",
            "fax_number": "509-758-9664"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 6TH ST",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994032010",
            "telephone_number": "509-758-9698",
            "fax_number": "509-758-9664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FITZGERALD PSYCHOLOGICAL SERVICES, P.S.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-03",
        "last_updated": "2013-05-03",
        "status": "A",
        "authorized_official_last_name": "FITZGERALD",
        "authorized_official_first_name": "JAROD",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "LICENSED PSYCHOLOGIST",
        "authorized_official_telephone_number": "509-758-9698",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2013; 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.