Shavonna Fitzgerald, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093261 Issued in NY

Practice address

3100 E Genesee St
Syracuse, NY 13224-1647

Phone

(315) 435-6000

NPI assigned

Apr 10, 2015

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

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

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

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.

• Comprehensive Counseling LCSW, PLLC

  • Clinical Social Worker
  • Bayside, NY
  • NPI 1982798773
  NPD

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

{
    "created_epoch": "1428624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1710373386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241647",
            "telephone_number": "315-435-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3100 E GENESEE ST",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132241647",
            "telephone_number": "315-435-6000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "819 S Salina St",
            "address_purpose": "LOCATION",
            "city": "Syracuse",
            "state": "NY",
            "postal_code": "132023527",
            "country_code": "US",
            "telephone_number": "315-476-7921",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "SHAVONNA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-10",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fitness Forum PT
• Jennifer Fitzgerald
• Lena Martha Fitzgerald, LCSW
• Michael A Fitzgerald, MD
• Michael G Fitzgerald, M.D.
• William Preston Fitzmaurice
• Eileen E Fitzpatrick, MS, CAS
• Molly Kim Fitzpatrick, DPT
• Taylor Fiumara, LMSW
• Kira Alvarado Fiutak, N.P.

• Clinical Social Worker in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2022; 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.

Verify at the official NPI Registry.