Provider Demographics
NPI:1316277023
Name:FITZPATRICK, MARGARET PATRICIA (LICSW)
Entity type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:PATRICIA
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1986 HOSEA WILLIAMS DRIVE NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-3807
Mailing Address - Country:US
Mailing Address - Phone:774-217-4105
Mailing Address - Fax:
Practice Address - Street 1:1986 HOSEA WILLIAMS DRIVE NE
Practice Address - Street 2:SUITE C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30317-1432
Practice Address - Country:US
Practice Address - Phone:774-217-4105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-31
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1134401041C0700X
GACSW0067351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical