Provider Demographics
NPI:1639239510
Name:FITZGERALD, KAREN MARIE (PHD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:MARIE
Last Name:FITZGERALD
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10721 MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:FAIRFAX
Mailing Address - State:VA
Mailing Address - Zip Code:22030-6902
Mailing Address - Country:US
Mailing Address - Phone:703-831-2040
Mailing Address - Fax:571-307-5494
Practice Address - Street 1:10721 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22030-6902
Practice Address - Country:US
Practice Address - Phone:702-831-2040
Practice Address - Fax:571-307-5494
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810003736103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical