Provider Demographics
NPI:1447926449
Name:FLEMING, ANTOINE (LCSW, CCM)
Entity type:Individual
Prefix:MR
First Name:ANTOINE
Middle Name:
Last Name:FLEMING
Suffix:
Gender:M
Credentials:LCSW, CCM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15203 SNOWDROP FIELD DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-5123
Mailing Address - Country:US
Mailing Address - Phone:832-506-1701
Mailing Address - Fax:
Practice Address - Street 1:15203 SNOWDROP FIELD DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-5123
Practice Address - Country:US
Practice Address - Phone:832-506-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-08-19
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX519481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty