Kenna Marie Fitzpatrick, LGSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

29763 Issued in MN

Practice address

43 SE Main St Ste 226
Minneapolis, MN 55414-1094

Phone

(612) 324-9001

NPI assigned

May 2, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1620000000000",
    "number": "1801479456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7608 HEARTHSIDE WAY APT 4019",
            "city": "ELKRIDGE",
            "state": "MD",
            "postal_code": "210757366",
            "telephone_number": "443-975-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "43 SE MAIN ST STE 226",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554141094",
            "telephone_number": "612-324-9001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZPATRICK",
        "first_name": "KENNA",
        "middle_name": "MARIE",
        "credential": "LGSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-02",
        "last_updated": "2021-05-03",
        "certification_date": "2021-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MD",
            "license": "25319",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MN",
            "license": "29763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.starhauspsychotherapy.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Website URL",
            "address_1": "43 SE Main St Ste 226",
            "city": "Minneapolis",
            "state": "MN",
            "country_code": "US",
            "postal_code": "554141094",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Maura Fitzgerald, CNS
• Theresa Mangahas Fitzgerald, MD
• Abigail Eleanor Fitzgibbons
• Anne Marie Fitzgibbons, OTR
• Kinsey Marie Fitzloff, LGSW
• John M Fitzsimmons, MD
• Margaret Lydia Carlson Fitzthum, RN, NP-C
• Holly C Fix, CPM, LM
• Andrea Fjeldberg
• Jerry Fjerkenstad, LP

• Social Worker in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Social Worker in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2021; 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.