Fitzgerald, Jenna R
Fitzgerald, Jenna R is an individual health care provider with primary practice located at 3959 Electric Rd Ste 425 , Roanoke VA 24018-4563. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Fitzgerald, Jenna R can be contacted via phone (540) 206-2385.Contact Information
Primary practice address
3959 Electric Rd Ste 425
Roanoke VA 24018-4563
Phone: (540) 206-2385
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | 0701007605 | Virginia |
Profile Details
| NPI number | 1871848283 |
|---|---|
| LBN Legal business name | Fitzgerald, Jenna R |
| Credentials | PHD LPC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 23rd, 2012 |
| Last updated | Nov 24th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871848283 | NPPES |
| Kentucky | MEDICAID | 30604011 |
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