Provider Demographics
NPI:1780933606
Name:FLEMING, BETH ELLEN (MASTER SOCIAL WORKER)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:ELLEN
Last Name:FLEMING
Suffix:
Gender:F
Credentials:MASTER SOCIAL WORKER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O.BOX 492564
Mailing Address - Street 2:
Mailing Address - City:KEAAU
Mailing Address - State:HI
Mailing Address - Zip Code:96749-2564
Mailing Address - Country:US
Mailing Address - Phone:208-406-3170
Mailing Address - Fax:
Practice Address - Street 1:16-1781 40TH STREET
Practice Address - Street 2:
Practice Address - City:KEAAU
Practice Address - State:HI
Practice Address - Zip Code:96749
Practice Address - Country:US
Practice Address - Phone:208-406-3170
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-06
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor