MEDICARE: FITZGERALD AND ASSOCIATES BEHAVIORAL HEALTH GROUP

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	261QM0850X	Adult Mental Health Clinic/Center
2	261QM0855X	Adolescent and Children Mental Health Clinic/Center
3	174400000X	Specialist
4	251B00000X	Case Management Agency
5	251S00000X	Community/Behavioral Health Agency
6	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1497454243
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FITZGERALD AND ASSOCIATES BEHAVIORAL HEALTH GROUP

Provider Business Mailing Address
First Line	:	1534 WOODWARD HEIGHTS WAY
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89032-7794
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	4100 W FLAMINGO RD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89103-3924
Country	:	US
Telephone Number	:	888-510-0850
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	DEJA FITZGERALD
Credential	:
Telephone Number	:	702-714-3894

Provider Enumeration Date	:	03/01/2023
Last Update Date	:	03/01/2023

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