Provider Demographics
NPI:1619620507
Name:FRANCIS IACOBUCCI COUNSELING
Entity Type:Organization
Organization Name:FRANCIS IACOBUCCI COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANCIS
Authorized Official - Middle Name:REGINALD
Authorized Official - Last Name:IACOBUCCI
Authorized Official - Suffix:III
Authorized Official - Credentials:LCSW
Authorized Official - Phone:484-437-1163
Mailing Address - Street 1:715 20TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4015
Mailing Address - Country:US
Mailing Address - Phone:484-437-1163
Mailing Address - Fax:
Practice Address - Street 1:4 RAYMOND DR STE F
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-3188
Practice Address - Country:US
Practice Address - Phone:484-437-1163
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-31
Last Update Date:2022-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health