Provider Demographics
NPI:1093822785
Name:YORK-FRANCO, JESSICA (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:
Last Name:YORK-FRANCO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6053 LOURDES RD
Mailing Address - Street 2:
Mailing Address - City:SANTA TERESA
Mailing Address - State:NM
Mailing Address - Zip Code:88008-9138
Mailing Address - Country:US
Mailing Address - Phone:915-227-1255
Mailing Address - Fax:877-587-9452
Practice Address - Street 1:444 EXECUTIVE CENTER BLVD
Practice Address - Street 2:STE. 210
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-1058
Practice Address - Country:US
Practice Address - Phone:915-227-1255
Practice Address - Fax:877-587-9452
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19725101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX19725OtherL.P.C.
TX179266501Medicaid
TX20-4030941OtherTAX IDENTIFICATION NUMBER