Sean Kevin Fitzpatrick, MSW

Individual provider Active NPI Mental Health Counselor · Whiteman Afb, MO

NPI 1720071418 · NPPES record last updated Apr 12, 2018

Key facts

NPI
1720071418
Entity type
Individual (NPI type 1)
Primary specialty
Mental Health Counselor 101YM0800X
License
005969 (MO)
Practice address
331 Sijen Ave
Whiteman Afb, MO 65305-1269
Phone
(660) 687-4341
NPI assigned
Aug 26, 2005
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
005969MOMDMental Health Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 005969 MO Yes

Addresses

Primary practice location

331 Sijen Ave
Whiteman Afb, MO 65305-1269

Mailing address

331 Sijen Ave BLDG 2032
Whiteman Afb, MO 65305-1269
Phone (660) 687-4341

Other identifiers

IdentifierTypeStateIssuer
005969OtherMOLICENSE #
005969OtherMOMO LICENSE BOARD

Other providers in Whiteman Afb, MO

All providers in Whiteman Afb, MO · Mental Health Counselor in Missouri

Sources for this page

Verify at the official NPI Registry.