Provider Demographics
NPI:1144222811
Name:FRANCIS, JASON PAUL (LPC)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:PAUL
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6001 W WACO DR
Mailing Address - Street 2:SUITE M
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-6306
Mailing Address - Country:US
Mailing Address - Phone:254-772-8055
Mailing Address - Fax:254-772-3019
Practice Address - Street 1:6001 W WACO DR
Practice Address - Street 2:SUITE M
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-6306
Practice Address - Country:US
Practice Address - Phone:254-772-8055
Practice Address - Fax:254-772-3019
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-12
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4030LCOtherBLUE CROSS BLUE SHIELD TX