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NPI Code Detail

MEDICARE: MS. SUSAN R FLETCHER MSW LISW

MEDICARE: MS. SUSAN R FLETCHER MSW LISW
Medicare Provider Information

Scope of Practice

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

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerI0009490OH

General Provider Information

NPI Number : 1154590818
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SUSAN R FLETCHER MSW LISW
Provider Business Mailing Address
First Line : 210 S 2ND ST
Second Line : STE 2
City : HAMILTON
State : OH
Zip : 45011-2802
Country : US
Telephone Number : 513-454-1462
Fax Number : 513-454-1462
Provider Business Practice Location Address
First Line : 1036 S VERITY PKWY
Second Line :
City : MIDDLETOWN
State : OH
Zip : 45044-5513
Country : US
Telephone Number : 513-454-1111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2008
Last Update Date : 08/10/2020

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