Provider Demographics
NPI:1588277537
Name:FRITZGERALD, ABIGAIL (LMHCA)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:
Last Name:FRITZGERALD
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1353 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-1433
Mailing Address - Country:US
Mailing Address - Phone:317-520-4748
Mailing Address - Fax:888-498-5529
Practice Address - Street 1:1353 E MAIN ST
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-1433
Practice Address - Country:US
Practice Address - Phone:317-520-4748
Practice Address - Fax:888-498-5529
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2020-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.014899101YM0800X
IN88001221A101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health