| Doug Fitzgerald, | |
|
3444 Wisconsin Ave, Vicksburg, MS 39180-5331 | |
| (601) 638-0031 | |
| (601) 638-4950 |
| Full Name | Doug Fitzgerald |
|---|---|
| Gender | Male |
| Speciality | Mental Health Counselor |
| Experience | 31 Years |
| Location | 3444 Wisconsin Ave, Vicksburg, Mississippi |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417130600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Positive Pathways, Llc | 0648678425 | 9 |
| Entity Name | Positive Pathways, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801335492 PECOS PAC ID: 0648678425 Enrollment ID: O20211021000305 |
| Mailing Address | Practice Location Address |
|---|---|
| Doug Fitzgerald, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (601) 638-0031 | Doug Fitzgerald, 3444 Wisconsin Ave, Vicksburg, MS 39180-5331 Ph: (601) 638-0031 |
Kaila Virgil, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3334 Wisconsin Ave., Vicksburg, MS 39180 Phone: 601-638-0031 | |
Tiffany Smith, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Felicia Wilson, PCMHT Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Heather Potts, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Rosalyn Glascoe, Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 | |
Ann Nelson, LSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 3444 Wisconsin Ave, Vicksburg, MS 39180 Phone: 601-638-0031 Fax: 601-638-4950 | |
Mr. Walter Lee Frazier, MCP, LPC, NCC Counselor Medicare: Accepting Medicare Assignments Practice Location: 1414 Cherry St, Vicksburg, MS 39180 Phone: 601-636-5703 Fax: 601-636-5739 |