Provider Demographics
NPI:1891689923
Name:FLETCHER, LORI ANN (LLMSW)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:NEMETHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:246 E KILGORE RD
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49002-0507
Mailing Address - Country:US
Mailing Address - Phone:269-249-7179
Mailing Address - Fax:
Practice Address - Street 1:246 E KILGORE RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-0507
Practice Address - Country:US
Practice Address - Phone:269-249-7179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6851117811104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker