MEDICARE: MRS. FRAN MARIE ALBRIGHT ACSW, 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	101YM0800X	Mental Health Counselor	000492	MO

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	77661	OTHER	MO	MEDICARE PROVIDER NUMBER

General Provider Information

NPI Number	:	1932358066
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FRAN MARIE ALBRIGHT ACSW, LCSW

Provider Business Mailing Address
First Line	:	5115 FLAMETREE CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-2415
Country	:	US
Telephone Number	:	314-974-0989
Fax Number	:	314-845-6818

Provider Business Practice Location Address
First Line	:	5115 FLAMETREE CT
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63129-2415
Country	:	US
Telephone Number	:	314-974-0989
Fax Number	:	314-845-6818

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

Provider Enumeration Date	:	09/12/2008
Last Update Date	:	09/12/2008

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