Alexandra Fitzgibbon, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

6801092225 Issued in MI

Practice address

5024 N Royal Dr Ste B
Traverse City, MI 49684-9230

Phone

(231) 409-6004

NPI assigned

Sep 2, 2021

Sex

Female

Sole proprietor

Yes

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

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Richard Kneip, PH.D., P.C.

  • Community/Behavioral Health Agency
  • Clarkston, MI
  • NPI 1679739700
  Medicare reassignment NPD

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

{
    "created_epoch": "1630540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630540800000",
    "number": "1992473060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5024 N ROYAL DR STE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849230",
            "telephone_number": "231-409-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5024 N ROYAL DR STE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496849230",
            "telephone_number": "231-409-6004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGIBBON",
        "first_name": "ALEXANDRA",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-09-02",
        "last_updated": "2021-09-02",
        "certification_date": "2021-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MI",
            "license": "6801092225",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Robert Fisher, DDS
• Larissa Lynn Fisher, PA
• Chase Anthony Fitch
• Fitness Center Physical Therapy
• Marylin Fitzgerald, M.A. LLP
• Chelsea Renell Fitzpatrick, RD
• Hailey Elizabeth Fitzpatrick
• Lisa Fitzpatrick, OTR/CHT,CAE,CEAS
• Daniel O Flansburg
• Emma Lizette Flees

• Clinical Social Worker in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Clinical Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.