Provider Demographics
NPI:1326100819
Name:FLEMING, JOSEPHINE MARY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOSEPHINE
Middle Name:MARY
Last Name:FLEMING
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 1:320 LAKE AVENUE
Mailing Address - Street 2:SUITE 1
Mailing Address - City:ST JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-2255
Mailing Address - Country:US
Mailing Address - Phone:631-862-9346
Mailing Address - Fax:
Practice Address - Street 1:320 LAKE AVENUE
Practice Address - Street 2:SUITE 1
Practice Address - City:ST JAMES
Practice Address - State:NY
Practice Address - Zip Code:11780-2255
Practice Address - Country:US
Practice Address - Phone:631-862-9346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN6B741Medicare ID - Type Unspecified