Provider Demographics
NPI:1629456579
Name:FLECKENSTEIN, ASHLEY MICHELE (MSW)
Entity Type:Individual
Prefix:MISS
First Name:ASHLEY
Middle Name:MICHELE
Last Name:FLECKENSTEIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1842 W GRACE ST
Mailing Address - Street 2:APT 3
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23220-2120
Mailing Address - Country:US
Mailing Address - Phone:804-625-2305
Mailing Address - Fax:
Practice Address - Street 1:200 N 22ND ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23223-7020
Practice Address - Country:US
Practice Address - Phone:804-644-9590
Practice Address - Fax:804-649-2151
Is Sole Proprietor?:No
Enumeration Date:2015-05-12
Last Update Date:2015-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA004945182Medicaid