Healthcare Provider Details
I. General information
NPI: 1285812354
Provider Name (Legal Business Name): EMILY MCLAUGHLIN FITZGERALD LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/31/2008
Last Update Date: 06/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
620 COURT ST
LYNCHBURG VA
24504-1312
US
IV. Provider business mailing address
2215 LANGHORNE RD
LYNCHBURG VA
24501-1121
US
V. Phone/Fax
- Phone: 434-948-4831
- Fax: 434-485-8877
- Phone: 434-948-4831
- Fax: 434-485-8877
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YP2500X |
| Taxonomy | Professional Counselor |
| License Number | 0701006152 |
| License Number State | VA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 104100000X |
| Taxonomy | Social Worker |
| License Number | |
| License Number State | NULL |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: