Individual provider Active NPI

Jeanne Marie Flesch, LCSW

  • Clinical Social Worker
  • Rockford, IL
National Provider Identifier
1083771901
Registry record updated Oct 3, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149001409 Issued in IL
Practice address
415 S Mulford Rd
Rockford, IL 61108-3011
Phone
(815) 397-4540
Fax
(815) 398-4896
NPI assigned
Jan 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 3, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149001409 IL Primary
Clinical Social Worker 1041C0700X 3707123 WI

Addresses

Primary practice location

415 S Mulford Rd
Rockford, IL 61108-3011

Mailing address

415 S Mulford Rd
Rockford, IL 61108-3011
Phone (815) 397-4540

Other names 1

  • Jeanne Marie Hughes Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149001409ILMDClinical Social Worker
3707123WIMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1167696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1475452800000",
    "number": "1083771901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083011",
            "telephone_number": "815-397-4540",
            "fax_number": "815-398-4896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "415 S MULFORD RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611083011",
            "telephone_number": "815-397-4540",
            "fax_number": "815-398-4896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLESCH",
        "first_name": "JEANNE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-02",
        "last_updated": "2016-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149001409",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "3707123",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JEANNE",
            "last_name": "HUGHES",
            "middle_name": "MARIE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.