Jenna R Fitzgerald, PHD LPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0701007605 Issued in VA

Practice address

3959 Electric Rd Ste 425
Roanoke, VA 24018-4563

Phone

(540) 206-2385

NPI assigned

Jul 23, 2012

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breakforth Counseling and Consulting LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Roanoke, VA
  • NPI 1609490960
  NPD
• Lifeskills, Inc.

  • Community/Behavioral Health Agency
  • Bowling Green, KY
  • NPI 1669401816
  NPD (past)

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

{
    "created_epoch": "1343001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1637712000000",
    "number": "1871848283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3959 ELECTRIC RD STE 425",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184563",
            "telephone_number": "540-524-0359"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3959 ELECTRIC RD STE 425",
            "city": "ROANOKE",
            "state": "VA",
            "postal_code": "240184563",
            "telephone_number": "540-206-2385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "JENNA",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PHD LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-07-23",
        "last_updated": "2021-11-24",
        "certification_date": "2021-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "VA",
            "license": "0701007605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30604011",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy Katelyn Fisher, CRNA
• Jennifer Lynn Fisher, OTR/L
• Matthew Fisher, CRNA, RN
• Michael Jacob Fisher, CSAC-S,
• David Kyle Fitzgerald, DDS
• Kiley F Fitzgerald, MD
• Mary Fitzgerald, CRNA
• Fielding Carter Fitzpatrick, DO
• Vicki Lee Fitzpatrick, PA-C
• Gretchen Renee Flack, LPC

• Mental Health Counselor in Roanoke, VA
• Providers in Roanoke, VA by specialty
• Mental Health Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 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.