Healthcare Provider Details

I. General information

NPI: 1659911006
Provider Name (Legal Business Name): RENEE Y FLEMING LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/14/2020
Last Update Date: 03/23/2023
Certification Date: 03/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 WALNUT ST.
COSHOCTON OH
43812-1655
US

IV. Provider business mailing address

610 WALNUT ST.
COSHOCTON OH
43812-1655
US

V. Phone/Fax

Practice location:
  • Phone: 740-622-0033
  • Fax: 740-622-0210
Mailing address:
  • Phone: 740-622-0033
  • Fax: 740-622-0210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberS.1502425
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS.1502425
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: