Provider Demographics
NPI:1538570197
Name:FLESHMAN, KARLA (LCSW, MDIV)
Entity type:Individual
Prefix:
First Name:KARLA
Middle Name:
Last Name:FLESHMAN
Suffix:
Gender:F
Credentials:LCSW, MDIV
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 VILLAGE RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1356
Mailing Address - Country:US
Mailing Address - Phone:610-724-3542
Mailing Address - Fax:
Practice Address - Street 1:1305 KIRKWOOD HWY
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-2121
Practice Address - Country:US
Practice Address - Phone:610-724-3542
Practice Address - Fax:302-351-7208
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-16
Last Update Date:2020-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE250424205Medicaid