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General NPI Number Information
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NPI Number | 1649132168
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Entity Type | Individual
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Provider Name | REGINA EVE FITZPATRICK MS, EDD, NCC
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Gender | Female
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/02/2025
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Provider Practice Location Address
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Address Line | 28 MINEAH RD
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City | FREEVILLE
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State | NY
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Zip | 13068-9522
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Country | US
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Telephone | 607-425-2848
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Fax |
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Provider Business Mailing Address
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Address Line | 609 STEVENSON ST
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City | SAYRE
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State | PA
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Zip | 18840-1411
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Country | US
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Telephone | 607-425-2848
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 018-P139783
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License Number State | NY
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