Provider Demographics
NPI:1023528874
Name:DEANNA FLETCHER LMSW LLC
Entity type:Organization
Organization Name:DEANNA FLETCHER LMSW LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LMSW
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:810-215-1414
Mailing Address - Street 1:1122 N LEROY ST STE A
Mailing Address - Street 2:
Mailing Address - City:FENTON
Mailing Address - State:MI
Mailing Address - Zip Code:48430-2789
Mailing Address - Country:US
Mailing Address - Phone:810-215-1414
Mailing Address - Fax:
Practice Address - Street 1:1122 N LEROY ST STE A
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MI
Practice Address - Zip Code:48430-2789
Practice Address - Country:US
Practice Address - Phone:810-215-1414
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-06
Last Update Date:2019-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty