Provider Demographics
NPI:1982934683
Name:FLESHOOD, MARIA CLARK (LPC)
Entity type:Individual
Prefix:DR
First Name:MARIA
Middle Name:CLARK
Last Name:FLESHOOD
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14377 RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:VA
Mailing Address - Zip Code:23005-3131
Mailing Address - Country:US
Mailing Address - Phone:804-798-8404
Mailing Address - Fax:
Practice Address - Street 1:14377 RIVERSIDE DR
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:VA
Practice Address - Zip Code:23005-3131
Practice Address - Country:US
Practice Address - Phone:804-798-8404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701004050101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional