Healthcare Provider Details

I. General information

NPI: 1710722780
Provider Name (Legal Business Name): FRANCESCA MUSENGO LCSW-C LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2024
Last Update Date: 07/01/2024
Certification Date: 06/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1642 NATURO RD
TOWSON MD
21286-2346
US

IV. Provider business mailing address

1642 NATURO RD
TOWSON MD
21286-2346
US

V. Phone/Fax

Practice location:
  • Phone: 410-610-7491
  • Fax:
Mailing address:
  • Phone: 410-610-7491
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: FRANCESCA MUSENGO
Title or Position: OWNER
Credential: LCSW-C
Phone: 410-610-7491