Provider Demographics
NPI:1255925392
Name:HOAGUE, FLETCHER (LMSW)
Entity type:Individual
Prefix:
First Name:FLETCHER
Middle Name:
Last Name:HOAGUE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5127 PATTISON AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2039
Mailing Address - Country:US
Mailing Address - Phone:618-925-4909
Mailing Address - Fax:
Practice Address - Street 1:621 S NEW BALLAS RD STE 5003B
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-8270
Practice Address - Country:US
Practice Address - Phone:314-251-6933
Practice Address - Fax:314-251-8894
Is Sole Proprietor?:No
Enumeration Date:2021-03-01
Last Update Date:2021-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical