Provider Demographics
NPI:1366051872
Name:FLETCHER, TASHEEN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:TASHEEN
Middle Name:
Last Name:FLETCHER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4716 WEST ATLANTIC BLVD
Mailing Address - Street 2:APT 306
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33063
Mailing Address - Country:US
Mailing Address - Phone:954-415-2392
Mailing Address - Fax:
Practice Address - Street 1:4716 WEST ATLANTIC BLVD
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33063
Practice Address - Country:US
Practice Address - Phone:954-415-2392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-30
Last Update Date:2024-09-18
Deactivation Date:2022-04-12
Deactivation Code:
Reactivation Date:2024-09-18
Provider Licenses
StateLicense IDTaxonomies
FLSW173261041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical