Basic Information
| Provider Information | |||||||||
| NPI: | 1215070883 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | FLEMING | ||||||||
| FirstName: | DEBORAH | ||||||||
| MiddleName: | D. | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | MA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3963 HARTLAND RD | ||||||||
| Address2: | |||||||||
| City: | LENOIR | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286458509 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287581938 | ||||||||
| FaxNumber: | 8287581938 | ||||||||
| Practice Location | |||||||||
| Address1: | 207 QUEEN ST | ||||||||
| Address2: | |||||||||
| City: | MORGANTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 286553341 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284398191 | ||||||||
| FaxNumber: | 8284392622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/14/2007 | ||||||||
| LastUpdateDate: | 07/23/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | 1907 | NC | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 046HY | 01 | NC | BCBS | OTHER | 017X7 | 01 | NC | BCBS GROUP | OTHER | 191819 | 01 | NC | MEDCOST | OTHER | 6107198 | 05 | NC | MEDICAID |