Healthcare Provider Details

I. General information

NPI: 1548122161
Provider Name (Legal Business Name): OLIVIA FITZPATRICK PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 COGSWELL AVE UNIT 1
CAMBRIDGE MA
02140-2001
US

IV. Provider business mailing address

14 COGSWELL AVE UNIT 1
CAMBRIDGE MA
02140-2001
US

V. Phone/Fax

Practice location:
  • Phone: 513-382-6842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY10002115
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: