Provider Demographics
NPI:1437455615
Name:FITZPATRICK, ABIGAIL GEFFEN (LCSWR)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:GEFFEN
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HENRY W DUBOIS DR
Mailing Address - Street 2:# 7
Mailing Address - City:NEW PALTZ
Mailing Address - State:NY
Mailing Address - Zip Code:12561-1516
Mailing Address - Country:US
Mailing Address - Phone:845-417-8906
Mailing Address - Fax:
Practice Address - Street 1:36 HENRY W DUBOIS DR
Practice Address - Street 2:# 7
Practice Address - City:NEW PALTZ
Practice Address - State:NY
Practice Address - Zip Code:12561-1516
Practice Address - Country:US
Practice Address - Phone:845-417-8906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-04
Last Update Date:2011-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYRO7152511041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical