Provider Demographics
NPI:1073702296
Name:FLETCHER, DONNA GAIL (LCSW)
Entity Type:Individual
Prefix:MS
First Name:DONNA
Middle Name:GAIL
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 COURT ST
Mailing Address - Street 2:SUITE 42
Mailing Address - City:NORWICH
Mailing Address - State:NY
Mailing Address - Zip Code:13815-1695
Mailing Address - Country:US
Mailing Address - Phone:607-667-1600
Mailing Address - Fax:607-334-4519
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-667-1600
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2007-10-24
Last Update Date:2014-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY077191-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical