Provider Demographics
NPI:1033233291
Name:FRANCIS, KIM CARLISLE (EDD)
Entity Type:Individual
Prefix:DR
First Name:KIM
Middle Name:CARLISLE
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 KENT DR
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2332
Mailing Address - Country:US
Mailing Address - Phone:908-665-8975
Mailing Address - Fax:908-665-8975
Practice Address - Street 1:130 KENT DR
Practice Address - Street 2:
Practice Address - City:BERKELEY HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07922-2332
Practice Address - Country:US
Practice Address - Phone:908-665-8975
Practice Address - Fax:908-665-8975
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ3017103T00000X, 103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling