Healthcare Provider Details

I. General information

NPI: 1255173944
Provider Name (Legal Business Name): FRANTZCES LYS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2024
Last Update Date: 06/12/2024
Certification Date: 06/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 PLEASANT ST STE 104
BROCKTON MA
02301-2533
US

IV. Provider business mailing address

425 PLEASANT ST STE 104
BROCKTON MA
02301-2533
US

V. Phone/Fax

Practice location:
  • Phone: 508-269-9695
  • Fax: 508-425-3048
Mailing address:
  • Phone: 508-269-9695
  • Fax: 508-425-3048

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW230566
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: