Provider Demographics
NPI:1508010257
Name:FRANCOEUR, MYRIAM (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MYRIAM
Middle Name:
Last Name:FRANCOEUR
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 OLD COUNTY WAY
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-1337
Mailing Address - Country:US
Mailing Address - Phone:508-250-3040
Mailing Address - Fax:508-427-4382
Practice Address - Street 1:320 MAIN ST
Practice Address - Street 2:BASU-4TH FLOOR
Practice Address - City:BROCKTON
Practice Address - State:MA
Practice Address - Zip Code:02301-5323
Practice Address - Country:US
Practice Address - Phone:508-897-1255
Practice Address - Fax:508-427-4382
Is Sole Proprietor?:No
Enumeration Date:2008-11-07
Last Update Date:2008-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical