Healthcare Provider Details

I. General information

NPI: 1487342879
Provider Name (Legal Business Name): ALEXIS FRANCISCO LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2023
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 GROVE ST
GARNERVILLE NY
10923-1210
US

IV. Provider business mailing address

19 GROVE ST
GARNERVILLE NY
10923-1210
US

V. Phone/Fax

Practice location:
  • Phone: 917-645-7832
  • Fax:
Mailing address:
  • Phone: 845-232-0909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number098275
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: