Healthcare Provider Details

I. General information

NPI: 1265049613
Provider Name (Legal Business Name): MEGHAN FITZGERALD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2020
Last Update Date: 03/20/2026
Certification Date: 03/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BERRYVILLE AVE
WINCHESTER VA
22601-5900
US

IV. Provider business mailing address

9376 BRIAR LN
DELAPLANE VA
20144-1907
US

V. Phone/Fax

Practice location:
  • Phone: 540-773-3999
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number0810009194
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: