Provider Demographics
NPI:1194921221
Name:FLETCHER, ROBB (LCSW)
Entity type:Individual
Prefix:MR
First Name:ROBB
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 FIR CT
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4019
Mailing Address - Country:US
Mailing Address - Phone:504-347-8808
Mailing Address - Fax:
Practice Address - Street 1:4728 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:JEFFERSON
Practice Address - State:LA
Practice Address - Zip Code:70121-3125
Practice Address - Country:US
Practice Address - Phone:504-734-0501
Practice Address - Fax:504-734-3707
Is Sole Proprietor?:No
Enumeration Date:2007-06-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA54601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical