Brent L. Fletcher, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

2000151679 Issued in MO

Practice address

1312 E Lark St
Springfield, MO 65804-7351

Phone

(417) 820-3707

Fax

(417) 820-7954

NPI assigned

Feb 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: bfletcher879@directb.mercy.net

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216684800000",
    "number": "1538203278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1312 E LARK ST",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658047351",
            "telephone_number": "417-820-3707",
            "fax_number": "417-820-7954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "BRENT",
        "middle_name": "L.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2000151679",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE SHIELD #",
            "identifier": "83790",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495079204",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gabriel Fleer, ATC, LAT, CSCS
• Laura C. Fleetwood, ANP-C
• Justin A Fleming, MS, LPC, NCC
• Robert Wilson Fleming, PT
• Ashley Christine Fletcher, LCSW
• Shelby K Fletcher, PLPC
• Janie Flint, OTR/L
• Bailey E Flood, MS, PA
• Sara Jo Flora, M.S. CFY-SLP
• Christine M Flores, MSW, LCSW

• Clinical Social Worker in Springfield, MO
• Providers in Springfield, MO by specialty
• Clinical Social Worker in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.