Provider Demographics
NPI:1609991025
Name:FLEMING, JOANN THOMPSON (LMFT)
Entity Type:Individual
Prefix:
First Name:JOANN
Middle Name:THOMPSON
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 UPTON ST # 2
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-1609
Mailing Address - Country:US
Mailing Address - Phone:617-437-6780
Mailing Address - Fax:
Practice Address - Street 1:45 NEWBURY ST
Practice Address - Street 2:SUITE 505
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-3133
Practice Address - Country:US
Practice Address - Phone:617-572-3716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1228106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist