Healthcare Provider Details

I. General information

NPI: 1750642252
Provider Name (Legal Business Name): STEPHANIE C FRANCIS LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2012
Last Update Date: 06/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 US HWY 1 SUITE 2
VERONA ISLAND ME
04416-3015
US

IV. Provider business mailing address

46 BLUEBERRY HILL RD
WINTERPORT ME
04496-4614
US

V. Phone/Fax

Practice location:
  • Phone: 207-223-4282
  • Fax:
Mailing address:
  • Phone: 207-223-4282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC2746
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: