Fitzpatrick, Phillip David

Fitzpatrick, Phillip David is an sole proprietor health care provider with primary practice located at 6600 Sanger Ave Suite # 9, Waco TX 76710-7814. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Fitzpatrick, Phillip David can be contacted via phone (254) 722-6247.

Contact Information

Primary practice address
6600 Sanger Ave Suite # 9 Waco TX 76710-7814
Phone: (254) 722-6247
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Social Worker 104100000X 16268 Texas

Profile Details

NPI number 1538201322
LBN Legal business name Fitzpatrick, Phillip David
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 12th, 2007
Last updated Dec 9th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538201322 NPPES
Texas MEDICAID 103097504

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