Provider Demographics
NPI:1073702296
Name:FLETCHER, DONNA GAIL (LCSW-R)
Entity type:Individual
Prefix:MS
First Name:DONNA
Middle Name:GAIL
Last Name:FLETCHER
Suffix:
Gender:
Credentials:LCSW-R
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:GAIL
Other - Last Name:ALCOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:20 GENESEE ST APT A
Mailing Address - Street 2:
Mailing Address - City:GREENE
Mailing Address - State:NY
Mailing Address - Zip Code:13778-1217
Mailing Address - Country:US
Mailing Address - Phone:607-371-1369
Mailing Address - Fax:607-217-4253
Practice Address - Street 1:76 BROAD AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904-1406
Practice Address - Country:US
Practice Address - Phone:607-371-1369
Practice Address - Fax:607-217-4253
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-24
Last Update Date:2025-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0771911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty