Provider Demographics
NPI:1689156440
Name:FRITCHLEY, JOSEPH R (LLMSW)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:R
Last Name:FRITCHLEY
Suffix:
Gender:M
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:541 COTTON CREEK DR
Mailing Address - Street 2:
Mailing Address - City:GULF SHORES
Mailing Address - State:AL
Mailing Address - Zip Code:36542-9047
Mailing Address - Country:US
Mailing Address - Phone:251-278-0004
Mailing Address - Fax:
Practice Address - Street 1:541 COTTON CREEK DR
Practice Address - Street 2:
Practice Address - City:GULF SHORES
Practice Address - State:AL
Practice Address - Zip Code:36542-9047
Practice Address - Country:US
Practice Address - Phone:251-278-0004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-29
Last Update Date:2024-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL4426C101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional