MEDICARE: GLORIA J FLETCHER LCSW

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	1041C0700X	Clinical Social Worker	34003964A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447223441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GLORIA J FLETCHER LCSW

Provider Business Mailing Address
First Line	:	6626 E 75TH STREET
Second Line	:	SUITE 500
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2890
Country	:	US
Telephone Number	:	317-621-7561
Fax Number	:	317-355-6096

Provider Business Practice Location Address
First Line	:	6950 HILLSDALE CT
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46250-2040
Country	:	US
Telephone Number	:	317-621-7740
Fax Number	:	317-355-6096

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/09/2006
Last Update Date	:	11/09/2020

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