Look up the most recent NPI and PECOS records

Jenna T Fitzpatrick

Social Worker

Behavioral Health & Social Service Providers

5311 W Newport Ave, Chicago, IL 60641-3333

PECOS Enrollment

Based on the most recent information from CMS, provider Jenna T Fitzpatrick does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 12:57 PM.

Profile Details

Provider ID
1215247366
Provider Type
Individual
Full Name
Fitzpatrick, Jenna T
Credential
LCSW

Gender
Female
Sole Proprietor
No
Enumeration Date
10/7/2010
Last Updated
5/8/2014

Contact Information

Practice Location

5311 W Newport Ave, Chicago, IL 60641-3333

(518) 330-6503

Unlisted Fax

Mailing Location

5311 W Newport Ave, Chicago, IL 60641-3333

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 1041C0700X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 149016148 Illinois
Code 104100000X	Description Social Worker Behavioral Health & Social Service Providers	License 074652-1 New York
Code 1041C0700X	Description Social Worker Behavioral Health & Social Service Providers	License 080606-1 New York

Jenna T Fitzpatrick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Smith, Deborah Ellen

Brickey, Corrie

George, Courtney

Valbuena, Jill

Seaweed Wellness Pllc

Gillogly, Zaya A

Caddell, Katharine

Goldfarb, Yehudis

Orozco, Karina

Mixon, Miriam A