Provider Demographics
NPI:1881026805
Name:FLEMMER, JACQUELYN RACHEL VANHOUT (LMSW)
Entity Type:Individual
Prefix:
First Name:JACQUELYN
Middle Name:RACHEL VANHOUT
Last Name:FLEMMER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:JACQUELYN
Other - Middle Name:RACHEL
Other - Last Name:VAN HOUT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:30888 ROSEMOND LN
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:MI
Mailing Address - Zip Code:48025-2165
Mailing Address - Country:US
Mailing Address - Phone:248-762-1342
Mailing Address - Fax:
Practice Address - Street 1:30150 TELEGRAPH RD STE 245
Practice Address - Street 2:
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025-4521
Practice Address - Country:US
Practice Address - Phone:248-762-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011166091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical