MEDICARE: MS. MARGARET PATRICIA FITZPATRICK LICSW

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	1041C0700X	Clinical Social Worker	113440	MA
2	1041C0700X	Clinical Social Worker	CSW006735	GA

General Provider Information

NPI Number	:	1316277023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MARGARET PATRICIA FITZPATRICK LICSW

Provider Business Mailing Address
First Line	:	1986 HOSEA WILLIAMS DRIVE NE
Second Line	:	SUITE C
City	:	ATLANTA
State	:	GA
Zip	:	30317-3807
Country	:	US
Telephone Number	:	774-217-4105
Fax Number	:

Provider Business Practice Location Address
First Line	:	1986 HOSEA WILLIAMS DRIVE NE
Second Line	:	SUITE C
City	:	ATLANTA
State	:	GA
Zip	:	30317-1432
Country	:	US
Telephone Number	:	774-217-4105
Fax Number	:

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

Provider Enumeration Date	:	12/31/2009
Last Update Date	:	03/08/2022

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