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General NPI Number Information
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NPI Number | 1174853998
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Entity Type | Organization
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Legal Business Name | FRANCISCARE COUNSELING
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Dates
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Enumeration Date | 12/29/2009
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Last Update Date | 12/29/2009
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Provider Practice Location Address
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Address Line | 475 MARKET ST SUITE 103
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-3126
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Country | US
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Telephone | 201-791-1499
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Fax | 201-791-3529
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Provider Business Mailing Address
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Address Line | 475 MARKET ST SUITE 103
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City | ELMWOOD PARK
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State | NJ
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Zip | 07407-3126
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Country | US
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Telephone | 201-791-1499
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Fax | 201-791-3529
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | DR. JAMES PATRICK KELLY
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Credential | PHD
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Telephone | 201-791-1499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | SI01593
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License Number State | NJ
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