Provider Demographics
NPI:1467717850
Name:FRANCISCO, TIMOTHY JAMES (MA, LPCC)
Entity Type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:JAMES
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:MA, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4200 ZENITH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55410-1413
Mailing Address - Country:US
Mailing Address - Phone:612-817-5756
Mailing Address - Fax:
Practice Address - Street 1:11334 86TH AVE N
Practice Address - Street 2:
Practice Address - City:MAPLE GROVE
Practice Address - State:MN
Practice Address - Zip Code:55369-4528
Practice Address - Country:US
Practice Address - Phone:763-255-2125
Practice Address - Fax:763-225-2126
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-11
Last Update Date:2014-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN01180101YM0800X
MN00717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health