Provider Demographics
NPI:1750652988
Name:FRANCIS, LISA RAE (LCSW, LICSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:RAE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:LCSW, LICSW
Other - Prefix:MS
Other - First Name:LISA
Other - Middle Name:RAE
Other - Last Name:BURCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13203 SE 172ND AVE STE 166 MAIL BOX NUMBER: 313
Mailing Address - Street 2:
Mailing Address - City:HAPPY VALLEY
Mailing Address - State:OR
Mailing Address - Zip Code:97086
Mailing Address - Country:US
Mailing Address - Phone:971-421-7718
Mailing Address - Fax:
Practice Address - Street 1:13157 SE 132ND AVE
Practice Address - Street 2:
Practice Address - City:HAPPY VALLEY
Practice Address - State:OR
Practice Address - Zip Code:97086-8401
Practice Address - Country:US
Practice Address - Phone:714-217-7189
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-19
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW602546121041C0700X
ORL134181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical