Healthcare Provider Details

I. General information

NPI: 1285752543
Provider Name (Legal Business Name): CHRISTOPHER ROLAND FRANCO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2007
Last Update Date: 12/19/2019
Certification Date: 12/19/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4000 E CHARLESTON BLVD STE 230
LAS VEGAS NV
89104-6682
US

IV. Provider business mailing address

4000 E CHARLESTON BLVD STE 130
LAS VEGAS NV
89104-6659
US

V. Phone/Fax

Practice location:
  • Phone: 702-877-0684
  • Fax:
Mailing address:
  • Phone: 702-939-8570
  • Fax: 702-968-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number01327-L
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number7281-S
License Number StateNV
# 3
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberIC-1066
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: