Provider Demographics
NPI:1700118593
Name:FLECK, JOAN (LPC, LMFT)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:
Last Name:FLECK
Suffix:
Gender:F
Credentials:LPC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 25
Mailing Address - Street 2:
Mailing Address - City:HUME
Mailing Address - State:VA
Mailing Address - Zip Code:22639-0025
Mailing Address - Country:US
Mailing Address - Phone:540-364-1405
Mailing Address - Fax:
Practice Address - Street 1:8430 WEST MAIN STREET
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:VA
Practice Address - Zip Code:20115
Practice Address - Country:US
Practice Address - Phone:540-364-1405
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-04
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701001372101YM0800X
VA0717000746101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health