Provider Demographics
NPI:1851114508
Name:FITZPATRICK, AMANDA GAIL (MSW)
Entity type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:GAIL
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:GAIL
Other - Last Name:KINCHELOE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5919 COPPER MILL DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICKSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22407-9300
Mailing Address - Country:US
Mailing Address - Phone:571-375-6676
Mailing Address - Fax:
Practice Address - Street 1:8020 RIVER STONE DR
Practice Address - Street 2:
Practice Address - City:FREDERICKSBURG
Practice Address - State:VA
Practice Address - Zip Code:22407-8761
Practice Address - Country:US
Practice Address - Phone:530-834-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool