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General NPI Number Information
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NPI Number | 1245989144
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Entity Type | Individual
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Provider Name | ELIZABETH FITZGERALD MSW
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Gender | Female
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Dates
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Enumeration Date | 03/20/2022
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Last Update Date | 08/16/2022
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Provider Practice Location Address
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Address Line | 8800 WASHINGTON AVE
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City | MOUNT PLEASANT
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State | WI
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Zip | 53406-3701
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Country | US
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Telephone | 262-633-3591
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Fax | 262-633-2619
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Provider Business Mailing Address
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Address Line | 2743 S AUSTIN ST LOWR
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City | MILWAUKEE
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State | WI
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Zip | 53207-2007
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Country | US
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Telephone | 563-451-6557
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 132863-121
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License Number State | WI
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