MEDICARE: MEGHAN FITZGERALD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	0810009194	VA

General Provider Information

NPI Number	:	1265049613
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGHAN FITZGERALD

Provider Business Mailing Address
First Line	:	9376 BRIAR LN
Second Line	:
City	:	DELAPLANE
State	:	VA
Zip	:	20144-1907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1001 BERRYVILLE AVE
Second Line	:
City	:	WINCHESTER
State	:	VA
Zip	:	22601-5900
Country	:	US
Telephone Number	:	540-773-3999
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/29/2020
Last Update Date	:	03/20/2026

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