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NPI Code Detail

MEDICARE: DR. PAULA RICKERQ FLEMING PH.D., LPC

MEDICARE: DR. PAULA RICKERQ FLEMING PH.D., LPC
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
1101YM0800XMental Health Counselor002499MO

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1002499OTHERMOLPC LICENSE NUMBER

General Provider Information

NPI Number : 1184795320
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAULA RICKERQ FLEMING PH.D., LPC
Provider Business Mailing Address
First Line : 2708 CHAPEL WOOD TER
Second Line :
City : COLUMBIA
State : MO
Zip : 65203-5715
Country : US
Telephone Number : 573-356-0022
Fax Number :
Provider Business Practice Location Address
First Line : 4304 S BEARFIELD RD
Second Line :
City : COLUMBIA
State : MO
Zip : 65201-9557
Country : US
Telephone Number : 573-874-8686
Fax Number : 573-874-8608
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2006
Last Update Date : 07/08/2007

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