Provider Demographics
NPI:1639702657
Name:FLETCHER, EMILIA F (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:EMILIA
Middle Name:F
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 METROPLEX DR STE 200
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2684
Mailing Address - Country:US
Mailing Address - Phone:732-235-8400
Mailing Address - Fax:732-235-8395
Practice Address - Street 1:100 METROPLEX DR STE 200
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-2684
Practice Address - Country:US
Practice Address - Phone:732-235-8400
Practice Address - Fax:732-235-8395
Is Sole Proprietor?:No
Enumeration Date:2020-02-18
Last Update Date:2024-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC06397900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ44SC06397900OtherSOCIAL WORK EXAMINERS