Provider Demographics
NPI:1902818107
Name:FLEMING, PATRICK ANTHONY (PHD)
Entity Type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:ANTHONY
Last Name:FLEMING
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 MAIN ST
Mailing Address - Street 2:SUITE 5
Mailing Address - City:NORTHAMPTON
Mailing Address - State:MA
Mailing Address - Zip Code:01060-3128
Mailing Address - Country:US
Mailing Address - Phone:413-584-0390
Mailing Address - Fax:413-586-9458
Practice Address - Street 1:151 MAIN ST
Practice Address - Street 2:SUITE 5
Practice Address - City:NORTHAMPTON
Practice Address - State:MA
Practice Address - Zip Code:01060-3128
Practice Address - Country:US
Practice Address - Phone:413-584-0390
Practice Address - Fax:413-586-9458
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2016-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA22106H00000X
MA6281103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA017101OtherHARVARD PILGRIM HEALTHCAR
MAA079435OtherVALUEOPTIONS
MAW05037OtherBLUE CROSS & BLUE SHIELD
MA062295000OtherMAGELLAN BEHAVIORAL HEALT
MA27152OtherHEALTH NEW ENGLAND
MAA010102OtherVALUEOPTIONS MBHP
MAW05037OtherTRICARE
MA0522368Medicaid
MA06399OtherCIGNA BEHAVIORAL HEALTH
MAR43843Medicare UPIN
MAW05037Medicare ID - Type Unspecified