Provider Demographics
NPI:1730543448
Name:FLEET, MICHAEL PATRICK (LCSW)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:PATRICK
Last Name:FLEET
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3060 E TREMONT AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10461-5726
Mailing Address - Country:US
Mailing Address - Phone:718-239-1790
Mailing Address - Fax:718-239-6063
Practice Address - Street 1:3060 E TREMONT AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-5726
Practice Address - Country:US
Practice Address - Phone:718-239-1790
Practice Address - Fax:718-239-6063
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-08
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY088762104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker