Provider Demographics
NPI:1740844471
Name:FLETCHER, BARBARA ANN
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ANN
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1022 BRANDY LN APT 53
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:KY
Mailing Address - Zip Code:40475-8452
Mailing Address - Country:US
Mailing Address - Phone:859-625-8456
Mailing Address - Fax:
Practice Address - Street 1:1000 ACE DR
Practice Address - Street 2:
Practice Address - City:BEREA
Practice Address - State:KY
Practice Address - Zip Code:40403-1327
Practice Address - Country:US
Practice Address - Phone:859-756-5006
Practice Address - Fax:859-985-9665
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1558895631Medicaid