MEDICARE: MR. JOE FRANCISCO MSW, LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	6801082366	MI

General Provider Information

NPI Number	:	1225256712
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOE FRANCISCO MSW, LCSW

Provider Business Mailing Address
First Line	:	10808 CONCORD DR
Second Line	:
City	:	BERRIEN SPRINGS
State	:	MI
Zip	:	49103-9669
Country	:	US
Telephone Number	:	269-876-9337
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 N SAINT JOSEPH AVE
Second Line	:	SUITE G
City	:	NILES
State	:	MI
Zip	:	49120-2263
Country	:	US
Telephone Number	:	269-684-6870
Fax Number	:	574-252-4159

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	03/17/2011

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