Provider Demographics
NPI:1962108530
Name:FITZPATRICK, NICOLLE (LMHC)
Entity type:Individual
Prefix:
First Name:NICOLLE
Middle Name:
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 UPTON AVE UNIT 2
Mailing Address - Street 2:
Mailing Address - City:NORWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02062-4322
Mailing Address - Country:US
Mailing Address - Phone:508-745-0366
Mailing Address - Fax:
Practice Address - Street 1:77R W MAIN ST # R
Practice Address - Street 2:
Practice Address - City:HOPKINTON
Practice Address - State:MA
Practice Address - Zip Code:01748-1688
Practice Address - Country:US
Practice Address - Phone:508-435-5506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-06
Last Update Date:2023-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA13355-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health