Therese Gottfreid Fletcher, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

149018020 Issued in IL

Practice address

140 Marengo Ave
Forest Park, IL 60130-1379

Phone

(708) 267-1272

NPI assigned

Aug 22, 2019

Last updated

Aug 22, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: theresefletcher@tdh.allscriptsdirect.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

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  • Family Medicine Physician
  • Lewisville, TX
  • NPI 1245403567

  Clinical

  NPD

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

{
    "created_epoch": "1566432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566432000000",
    "number": "1588211775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 MARENGO AVE UNIT 103",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301316",
            "telephone_number": "708-267-1272"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 MARENGO AVE",
            "city": "FOREST PARK",
            "state": "IL",
            "postal_code": "601301379",
            "telephone_number": "708-267-1272"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "THERESE",
        "middle_name": "GOTTFREID",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-08-22",
        "last_updated": "2019-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149018020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Adrian Faulkner
• Robyn Felten, MS, RD, LDN, CNSC
• Bridget Finis, PSY.D.
• Beth Fischer
• Therese Fitzpatrick
• Rosalia Maria Foit, PT
• Forest Park Dental Associates LTD
• Forest Park School District 91
• Forest Park, L.L.C. (Pavillion of Forest Park, L.L.C.)
• Marco Formigoni, LCSW

• Clinical Social Worker in Forest Park, IL
• Providers in Forest Park, IL by specialty
• Clinical Social Worker in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2019; 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.