Provider Demographics
NPI:1104007251
Name:FLETCHER, RICHLYN PATRICIA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:RICHLYN
Middle Name:PATRICIA
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:172 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4546
Mailing Address - Country:US
Mailing Address - Phone:646-752-7395
Mailing Address - Fax:845-787-4801
Practice Address - Street 1:172 SOUTH ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4546
Practice Address - Country:US
Practice Address - Phone:646-752-7395
Practice Address - Fax:845-787-4801
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72050924104100000X
NY21205121041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool