Healthcare Provider Details

I. General information

NPI: 1073871166
Provider Name (Legal Business Name): KATHERINE MICHELLE FRANCIS MSW LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATHERINE MICHELLE ROSS MSW LICSW

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 10/16/2020
Certification Date: 10/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 S 31ST ST STE 201
GRAND FORKS ND
58201-3593
US

IV. Provider business mailing address

21081 COUNTRY HWY 1
FERGUS FALLS MN
56537
US

V. Phone/Fax

Practice location:
  • Phone: 701-780-6821
  • Fax: 701-780-1973
Mailing address:
  • Phone: 218-736-6987
  • Fax: 218-736-0734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number17889
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: