Provider Demographics
NPI:1669152930
Name:FLEMING, JOANNA (LPC)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1570 PEARL MILL RD
Mailing Address - Street 2:
Mailing Address - City:ELBERTON
Mailing Address - State:GA
Mailing Address - Zip Code:30635-5147
Mailing Address - Country:US
Mailing Address - Phone:706-988-0919
Mailing Address - Fax:
Practice Address - Street 1:1570 PEARL MILL RD
Practice Address - Street 2:
Practice Address - City:ELBERTON
Practice Address - State:GA
Practice Address - Zip Code:30635-5147
Practice Address - Country:US
Practice Address - Phone:706-988-0919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-21
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC013761101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional