Provider Demographics
NPI:1205143658
Name:FLETCHER COUNSELING PLLC
Entity type:Organization
Organization Name:FLETCHER COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:TOMMY
Authorized Official - Middle Name:LEROY
Authorized Official - Last Name:FLETCHER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW
Authorized Official - Phone:360-524-5879
Mailing Address - Street 1:201 NE PARK PLAZA DRIVE
Mailing Address - Street 2:SUITE 292
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98684
Mailing Address - Country:US
Mailing Address - Phone:360-524-5879
Mailing Address - Fax:360-326-1834
Practice Address - Street 1:201 NE PARK PLAZA DR
Practice Address - Street 2:SUITE 292
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-5808
Practice Address - Country:US
Practice Address - Phone:360-524-5879
Practice Address - Fax:360-326-1834
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-07
Last Update Date:2011-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00004883251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health