Provider Demographics
NPI:1376841957
Name:FLEMING, PATRICIA J (LMHC MT)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LMHC MT
Other - Prefix:
Other - First Name:RICIA
Other - Middle Name:
Other - Last Name:FLEMING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC MT
Mailing Address - Street 1:10 HAWKES ST
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3138
Mailing Address - Country:US
Mailing Address - Phone:781-639-4453
Mailing Address - Fax:
Practice Address - Street 1:10 HAWKES ST
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-3138
Practice Address - Country:US
Practice Address - Phone:781-639-4453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-07
Last Update Date:2011-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1922101YM0800X, 101YP2500X
MA711225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist