Provider Demographics
NPI:1083645808
Name:FLEMING, CONNIE (LPC)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4321 DOWNTOWNER LOOP NORTH
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36609
Mailing Address - Country:US
Mailing Address - Phone:251-455-2306
Mailing Address - Fax:
Practice Address - Street 1:4321 DOWNTOWNER LOOP N
Practice Address - Street 2:SUITE 105
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36609-5515
Practice Address - Country:US
Practice Address - Phone:251-455-2306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-06
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL912101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51516108OtherBCBS