Individual provider Active NPI

Tommy Leroy Fletcher, MSW

  • Mental Health Counselor
  • Longview, WA
National Provider Identifier
1659425619
Registry record updated Mar 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
720 14TH Ave
Longview, WA 98632-2315
Phone
(360) 423-0203
Fax
(360) 577-0187
NPI assigned
Jan 23, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

720 14TH Ave
Longview, WA 98632-2315

Mailing address

PO Box 1847
Longview, WA 98632-8140
Phone (360) 423-0203

Other identifiers 1

IdentifierTypeStateIssuer
A046OtherWATRICARE

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

Practice roles

OrganizationSpecialtyStatusNew patients
Fletcher Counseling PLLC Current Accepting new patients
Fletcher Counseling Mental Health Current Accepting new patients
Columbia Wellness CurrentSince Apr 24, 2022 Accepting new patients
Neurothryve Past Accepting new patients
Evergreen Behavioral Health PC Mental Health PastSince Nov 21, 2011 Accepting new patients

Locations

720 14th Ave
Longview, WA 98632

201 NE Park Plaza Dr
Ste 292
Vancouver, WA 98684
Phone (360) 524-5879

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1659425619",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986328140",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "720 14TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986322315",
            "telephone_number": "360-423-0203",
            "fax_number": "360-577-0187"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLETCHER",
        "first_name": "TOMMY",
        "middle_name": "LEROY",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TRICARE",
            "identifier": "A046",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.