Chastiti Fitzgerald, MS, LCADC, LAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Gloucester City, NJ
NPI 1801529342 · NPPES record last updated Oct 4, 2022
Key facts
- NPI
- 1801529342
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 37LC00356600 (NJ)
- Practice address
- 104 N King St
Gloucester City, NJ 08030-1417 - Phone
- (856) 742-0900
- NPI assigned
- Jul 1, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37LC00356600 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| My Father'S House, Inc | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37LC00356600 | NJ | Yes |
Addresses
Primary practice location
104 N King St
Gloucester City, NJ 08030-1417
Mailing address
104 N King St
Gloucester City, NJ 08030-1417
Phone (856) 742-0900
Other providers in Gloucester City, NJ
- Dr. Irving J. Klein,PA
- Dr. Larry Charles Wallis LLC
- Edward L. Lundy, D.O.
- Enam Corporation
- Keana Fairfax
- William Gladle
- Gloucester City Board of Education
- Kristina M Greco
- Healthy Smiles of Gloucester City
- Andrew Edward Herman
All providers in Gloucester City, NJ · Addiction (Substance Use Disorder) Counselor in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 4, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.