Mary Fitzgerald, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10455 Issued in MD

Practice address

5480 Wisconsin Ave Ste 225
Chevy Chase, MD 20815-3503

Phone

(202) 236-2160

NPI assigned

Jun 11, 2007

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2020 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542240000000",
    "number": "1902000474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE STE 225",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153503",
            "telephone_number": "202-236-2160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5480 WISCONSIN AVE STE 225",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208153503",
            "telephone_number": "202-236-2160"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4501 Connecticut Ave NW",
            "address_2": "Suite 217",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20008",
            "country_code": "US",
            "telephone_number": "202-236-2160",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4501 Connecticut Ave NW",
            "address_2": "Suite 217",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "20008",
            "country_code": "US",
            "telephone_number": "202-236-2160",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "MARY",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-11",
        "last_updated": "2018-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.