Provider Demographics
NPI:1912318494
Name:FLETCHER, DONNA (LCSW)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:EBERSOLD-FLETCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:1819 BAY SCOTT CIR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-1129
Mailing Address - Country:US
Mailing Address - Phone:630-357-2456
Mailing Address - Fax:630-284-6570
Practice Address - Street 1:1819 BAY SCOTT CIR
Practice Address - Street 2:SUITE 109
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-1129
Practice Address - Country:US
Practice Address - Phone:630-357-2456
Practice Address - Fax:630-284-6570
Is Sole Proprietor?:No
Enumeration Date:2014-05-18
Last Update Date:2017-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490057531041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical