Provider Demographics
NPI:1114223757
Name:FLEMING, ZACHARY MICHAEL (MA, MCAP)
Entity Type:Individual
Prefix:
First Name:ZACHARY
Middle Name:MICHAEL
Last Name:FLEMING
Suffix:
Gender:M
Credentials:MA, MCAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 PERIMETER PARK BLVD STE 402
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32216-1124
Mailing Address - Country:US
Mailing Address - Phone:904-719-3312
Mailing Address - Fax:904-719-3312
Practice Address - Street 1:8825 PERIMETER PARK BLVD STE 402
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32216-1124
Practice Address - Country:US
Practice Address - Phone:904-719-3312
Practice Address - Fax:904-719-3312
Is Sole Proprietor?:No
Enumeration Date:2011-01-30
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH101027101YA0400X
FLMCAP100202101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)