Melissa Mary Fitzgerald
Individual provider Active NPI Clinical Social Worker · Wind Lake, WI
NPI 1891479341 · NPPES record last updated Jun 22, 2023
Key facts
- NPI
- 1891479341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 10032123 (WI)
- Practice address
- 26326 Even Heg CT
Wind Lake, WI 53185-5525 - Phone
- (414) 793-9118
- NPI assigned
- Jun 14, 2023
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10032123 | WI | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10032123 | WI | Yes |
Addresses
Primary practice location
26326 Even Heg CT
Wind Lake, WI 53185-5525
Mailing address
26326 Even Heg CT
Wind Lake, WI 53185-5525
Phone (414) 793-9118
Other providers in Wind Lake, WI
- Affinity Health Care LLC
- Kimberly Banach
- Amy L Bluhm
- Erik R Burtraw
- Leah C. Clemence
- Makenzi Gordon
- Denise L Holterman
- Korine Ann Labodda
- Anne Marie Leidel
- Debra Ann Pokrzywinski
All providers in Wind Lake, WI · Clinical Social Worker in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2023. 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.