Active NPI
Jeanne Marie Flesch, LCSW
- Clinical Social Worker
- Rockford, IL
National Provider Identifier
1083771901
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149001409
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149001409 | IL | MD | Clinical Social Worker |
| 3707123 | WI | MD | Clinical 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.