Provider Demographics
NPI:1588376826
Name:FITZGERALD, WILLIAM V (LMHC)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:V
Last Name:FITZGERALD
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33712 MILL CREEK DR
Mailing Address - Street 2:
Mailing Address - City:ADEL
Mailing Address - State:IA
Mailing Address - Zip Code:50003-8458
Mailing Address - Country:US
Mailing Address - Phone:641-750-5707
Mailing Address - Fax:
Practice Address - Street 1:227 NW SCHOOL ST
Practice Address - Street 2:
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023-1746
Practice Address - Country:US
Practice Address - Phone:515-964-5003
Practice Address - Fax:515-964-3856
Is Sole Proprietor?:No
Enumeration Date:2022-12-19
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health