1134451115 NPI number — JANEAN MICHAEL FRANCIS LCSW

Table of content: JANEAN MICHAEL FRANCIS LCSW (NPI 1134451115)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134451115 NPI number — JANEAN MICHAEL FRANCIS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRANCIS
Provider First Name:
JANEAN
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SLOAN
Provider Other First Name:
JANEAN
Provider Other Middle Name:
MICHAEL
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134451115
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/30/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 132
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
REEDSPORT
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97467-0132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-407-8032
Provider Business Mailing Address Fax Number:
214-602-5295

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1877 WINCHESTER AVE STE 132
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
REEDSPORT
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97467-1148
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-407-8032
Provider Business Practice Location Address Fax Number:
214-602-5295
Provider Enumeration Date:
02/02/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  8164 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: L12153 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 104100000X , with the licence number: 5429-S , registered in the state of NV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 500795773 , issued by the state of ( OR ) . This identifiers is of the category "MEDICAID".