Healthcare Provider Details

I. General information

NPI: 1659957397
Provider Name (Legal Business Name): FRANCISCO CRUZ LECA LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2021
Last Update Date: 03/23/2021
Certification Date: 09/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1629 K ST NW STE 300
WASHINGTON DC
20006-1631
US

IV. Provider business mailing address

11710 ELLINGTON DR
BELTSVILLE MD
20705-1307
US

V. Phone/Fax

Practice location:
  • Phone: 240-393-8985
  • Fax:
Mailing address:
  • Phone: 254-449-2546
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number26542
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: