MEDICARE: MYEISHA FLEMING

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	101Y00000X	Counselor
2	101YA0400X	Addiction (Substance Use Disorder) Counselor
3	101YM0800X	Mental Health Counselor
4	101YP2500X	Professional Counselor

General Provider Information

NPI Number	:	1770281594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MYEISHA FLEMING

Provider Business Mailing Address
First Line	:	1944 N CROSKEY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-2027
Country	:	US
Telephone Number	:	215-416-4938
Fax Number	:

Provider Business Practice Location Address
First Line	:	1944 N CROSKEY ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19121-2027
Country	:	US
Telephone Number	:	215-416-4938
Fax Number	:

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

Provider Enumeration Date	:	02/21/2023
Last Update Date	:	02/21/2023

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Directions to “ MYEISHA FLEMING ” Practice Location

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