Provider Demographics
NPI:1508333881
Name:FLEISCHER, BRUCE ARNO (MS, PLPC, NCC)
Entity Type:Individual
Prefix:
First Name:BRUCE
Middle Name:ARNO
Last Name:FLEISCHER
Suffix:
Gender:M
Credentials:MS, PLPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:332 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:NEOSHO
Mailing Address - State:MO
Mailing Address - Zip Code:64850-1836
Mailing Address - Country:US
Mailing Address - Phone:417-592-0573
Mailing Address - Fax:
Practice Address - Street 1:5620 W WILDWOOD RANCH PKWY
Practice Address - Street 2:
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-4520
Practice Address - Country:US
Practice Address - Phone:417-623-1990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-25
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018033180101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health