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NPI Code Detail

MEDICARE: JENNIFER WHITNEY FITZGERALD LCP, PHD

MEDICARE: JENNIFER WHITNEY FITZGERALD LCP, PHD
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
1103TC0700XClinical Psychologist0810003076VA

General Provider Information

NPI Number : 1821001694
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER WHITNEY FITZGERALD LCP, PHD
Provider Business Mailing Address
First Line : 811 REDGATE AVE
Second Line :
City : NORFOLK
State : VA
Zip : 23507
Country : US
Telephone Number : 757-668-7007
Fax Number : 757-668-8658
Provider Business Practice Location Address
First Line : 601 CHILDRENS LN STE A
Second Line :
City : NORFOLK
State : VA
Zip : 23507-1971
Country : US
Telephone Number : 757-668-7473
Fax Number : 757-788-0932
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2006
Last Update Date : 01/05/2024

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