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General NPI Number Information
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NPI Number | 1205143658
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Entity Type | Organization
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Legal Business Name | FLETCHER COUNSELING PLLC
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Dates
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Enumeration Date | 09/07/2010
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Last Update Date | 12/23/2011
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Provider Practice Location Address
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Address Line | 201 NE PARK PLAZA DR SUITE 292
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City | VANCOUVER
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State | WA
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Zip | 98684-5808
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Country | US
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Telephone | 360-524-5879
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Fax | 360-326-1834
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Provider Business Mailing Address
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Address Line | 201 NE PARK PLAZA DRIVE SUITE 292
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City | VANCOUVER
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State | WA
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Zip | 98684
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Country | US
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Telephone | 360-524-5879
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Fax | 360-326-1834
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Authorized Official
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Title or Position | THERAPIST
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Name | MR. TOMMY LEROY FLETCHER
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Credential | M.S.W.
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Telephone | 360-524-5879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LW00004883
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License Number State | WA
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