Individual
MR. TYRONE FLEMING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LICENSE CLINICIAN
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
LCA455
MD
101YP2500X
Professional Counselor
Primary
LCA455
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCA455
LICENSE CLINICAL ALCOHOL & DRUG COUNSELOR
MD
Enumeration date
03/25/2014
Last updated
03/25/2014
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