Healthcare Provider Details

I. General information

NPI: 1386989374
Provider Name (Legal Business Name): CHELSEA RAE FLEMING LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2012
Last Update Date: 12/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 FREEDOM DR
NAPOLEON OH
43545-9038
US

IV. Provider business mailing address

15550 COUNTY ROAD F
BRYAN OH
43506-9444
US

V. Phone/Fax

Practice location:
  • Phone: 419-599-1660
  • Fax:
Mailing address:
  • Phone: 419-551-2390
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberS1201002
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: