MEDICARE: MATTHEW FLEMING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	E.0602071-SUPV	OH

General Provider Information

NPI Number	:	1033534979
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW FLEMING, LLC

Provider Business Mailing Address
First Line	:	3970 MOUNTVIEW RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43220-4856
Country	:	US
Telephone Number	:	614-264-5851
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 W 5TH AVE
Second Line	:	SUITE 102B
City	:	COLUMBUS
State	:	OH
Zip	:	43212-2503
Country	:	US
Telephone Number	:	614-264-5851
Fax Number	:	614-706-6066

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. MATTHEW SCOTT FLEMING
Credential	:	PCC-S
Telephone Number	:	614-264-5851

Provider Enumeration Date	:	03/02/2014
Last Update Date	:	10/13/2015

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