Individual provider Active NPI

Kelly L Fitzgerald, MA, LMHC

  • Mental Health Counselor
  • North Easton, MA
National Provider Identifier
1881716207
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6502 Issued in MA
Practice address
320 Washington St
North Easton, MA 02357-2717
Phone
(508) 565-1331
Fax
(508) 565-1691
NPI assigned
Apr 5, 2007
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X
Mental Health Counselor 101YM0800X 6502 MA Primary

Addresses

Primary practice location

320 Washington St
North Easton, MA 02357-2717

Mailing address

320 Washington St
North Easton, MA 02357-0001
Phone (508) 565-1331

Other practice location 1

99 Topeka St
Boston, MA 02118-2717
Phone (617) 442-1499 ext. 221

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
6502MAMDClinical Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1175731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1881716207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 WASHINGTON ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023570001",
            "telephone_number": "508-565-1331",
            "fax_number": "508-565-1691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 WASHINGTON ST",
            "city": "NORTH EASTON",
            "state": "MA",
            "postal_code": "023572717",
            "telephone_number": "508-565-1331",
            "fax_number": "508-565-1691"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "99 Topeka St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021182717",
            "country_code": "US",
            "telephone_number": "617-442-1499 x221",
            "fax_number": "617-442-1660",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "KELLY",
        "middle_name": "L",
        "name_prefix": "Ms.",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-05",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "6502",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Easton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 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.