Provider Demographics
NPI:1467798983
Name:FRECHETTE, JESSE M (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JESSE
Middle Name:M
Last Name:FRECHETTE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1405 REINER RD
Mailing Address - Street 2:
Mailing Address - City:EAGLEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19403-3852
Mailing Address - Country:US
Mailing Address - Phone:215-680-1944
Mailing Address - Fax:
Practice Address - Street 1:1101 BETHLEHEM PIKE
Practice Address - Street 2:FIRST FLOOR REAR OFFICE
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1939
Practice Address - Country:US
Practice Address - Phone:215-680-1944
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-02
Last Update Date:2013-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0153221041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical