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General NPI Number Information
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NPI Number | 1780802686
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Entity Type | Individual
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Provider Name | JAMES CONRAD FLEISCHMANN MS, CRC
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Gender | Male
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Dates
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Enumeration Date | 04/23/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 79 MIDDLEVILLE ROAD
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City | NORTHPORT
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State | NY
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Zip | 11768
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Country | US
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Telephone | 631-261-4400
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Fax | 631-221-6011
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Provider Business Mailing Address
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Address Line | 616 STANTON AVE
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City | NORTH BALDWIN
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State | NY
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Zip | 11510-1730
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Country | US
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Telephone | 516-410-3228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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