Provider Demographics
NPI:1184709230
Name:FLEMING, ANN (LCSW)
Entity type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:FLEMING
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:ROHLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:6121 GREEN BAY RD STE 230
Mailing Address - Street 2:
Mailing Address - City:KENOSHA
Mailing Address - State:WI
Mailing Address - Zip Code:53142-2929
Mailing Address - Country:US
Mailing Address - Phone:262-654-8366
Mailing Address - Fax:262-842-0444
Practice Address - Street 1:6121 GREEN BAY RD STE 230
Practice Address - Street 2:
Practice Address - City:KENOSHA
Practice Address - State:WI
Practice Address - Zip Code:53142-2929
Practice Address - Country:US
Practice Address - Phone:262-654-8366
Practice Address - Fax:262-842-0444
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI7038-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40941900Medicaid