Provider Demographics
NPI:1487729638
Name:FITZPATRICK, DENISE CORCORAN (LMHC)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:CORCORAN
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:PO BOX 225
Mailing Address - Street 2:
Mailing Address - City:SOUTH WALPOLE
Mailing Address - State:MA
Mailing Address - Zip Code:02071-0225
Mailing Address - Country:US
Mailing Address - Phone:508-668-4126
Mailing Address - Fax:
Practice Address - Street 1:16 NORTH ST
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02019-1713
Practice Address - Country:US
Practice Address - Phone:508-883-1308
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5523101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health