Provider Demographics
NPI:1699219618
Name:FRANCISCO, MARK (LCSW-PIP)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:
Last Name:FRANCISCO
Suffix:
Gender:M
Credentials:LCSW-PIP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1451 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:SD
Mailing Address - Zip Code:57006-1604
Mailing Address - Country:US
Mailing Address - Phone:605-670-8989
Mailing Address - Fax:
Practice Address - Street 1:1451 6TH ST
Practice Address - Street 2:
Practice Address - City:BROOKINGS
Practice Address - State:SD
Practice Address - Zip Code:57006-1604
Practice Address - Country:US
Practice Address - Phone:605-670-8989
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-09
Last Update Date:2022-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD51031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical