Provider Demographics
NPI:1760818819
Name:MISCIONE, FRANK ANGELO (LCSW)
Entity Type:Individual
Prefix:MR
First Name:FRANK
Middle Name:ANGELO
Last Name:MISCIONE
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12381 CHARLOMA DR
Mailing Address - Street 2:
Mailing Address - City:TUSTIN
Mailing Address - State:CA
Mailing Address - Zip Code:92780-2401
Mailing Address - Country:US
Mailing Address - Phone:714-473-1128
Mailing Address - Fax:
Practice Address - Street 1:12381 CHARLOMA DR
Practice Address - Street 2:
Practice Address - City:TUSTIN
Practice Address - State:CA
Practice Address - Zip Code:92780-2401
Practice Address - Country:US
Practice Address - Phone:714-473-1128
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-20
Last Update Date:2013-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS 83801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical