Healthcare Provider Details

I. General information

NPI: 1285239012
Provider Name (Legal Business Name): THOMAS MICHAEL FRANCUM LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/01/2020
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 S NATIONAL AVE STE 206
SPRINGFIELD MO
65807-7315
US

IV. Provider business mailing address

96 E CATAWBA ST APT 112M
BELMONT NC
28012-4242
US

V. Phone/Fax

Practice location:
  • Phone: 417-269-6891
  • Fax:
Mailing address:
  • Phone: 202-430-8707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC200002439
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2022008122
License Number StateMO
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC017892
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: