Provider Demographics
NPI:1942064076
Name:FITZPATRICK, NIAMH LISA (LCSWA)
Entity type:Individual
Prefix:
First Name:NIAMH
Middle Name:LISA
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 W CORBETT AVE STE 13
Mailing Address - Street 2:
Mailing Address - City:SWANSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28584-8437
Mailing Address - Country:US
Mailing Address - Phone:910-375-9157
Mailing Address - Fax:910-335-2897
Practice Address - Street 1:714 W CORBETT AVE STE 13
Practice Address - Street 2:
Practice Address - City:SWANSBORO
Practice Address - State:NC
Practice Address - Zip Code:28584-8437
Practice Address - Country:US
Practice Address - Phone:910-375-9157
Practice Address - Fax:910-335-2897
Is Sole Proprietor?:No
Enumeration Date:2024-02-08
Last Update Date:2025-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0201771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical