MEDICARE: ANGELA FITCH MA, LCPC

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	101YP2500X	Professional Counselor	178.009559	IL
2	101YM0800X	Mental Health Counselor	180010644	IL

General Provider Information

NPI Number	:	1982152997
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANGELA FITCH MA, LCPC

Provider Business Mailing Address
First Line	:	16 ASCOT CIR
Second Line	:
City	:	SCHAUMBURG
State	:	IL
Zip	:	60194-3678
Country	:	US
Telephone Number	:	630-886-4417
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 E NORTHWEST HWY STE 212
Second Line	:
City	:	PALATINE
State	:	IL
Zip	:	60067-1700
Country	:	US
Telephone Number	:	847-584-2339
Fax Number	:

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

Provider Enumeration Date	:	09/19/2016
Last Update Date	:	06/02/2022

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