Provider Demographics
NPI:1619582525
Name:FLETCHER, REBECCA ANN (LCSW, CADC)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:ANN
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LCSW, CADC
Other - Prefix:MISS
Other - First Name:REBECCA
Other - Middle Name:ANN
Other - Last Name:WARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW, CADC
Mailing Address - Street 1:238 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:62650-2348
Mailing Address - Country:US
Mailing Address - Phone:217-491-0741
Mailing Address - Fax:
Practice Address - Street 1:201 E MORGAN ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:IL
Practice Address - Zip Code:62650-2587
Practice Address - Country:US
Practice Address - Phone:217-245-1655
Practice Address - Fax:217-245-4742
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0127931041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical