Provider Demographics
NPI:1851765762
Name:KELLY FRANCINI LLC
Entity Type:Organization
Organization Name:KELLY FRANCINI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LCSW
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:FRANCINI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:973-864-4835
Mailing Address - Street 1:206 MAIN ST
Mailing Address - Street 2:SUITE 22
Mailing Address - City:MILLBURN
Mailing Address - State:NJ
Mailing Address - Zip Code:07041-1158
Mailing Address - Country:US
Mailing Address - Phone:973-864-4835
Mailing Address - Fax:973-218-8434
Practice Address - Street 1:206 MAIN ST
Practice Address - Street 2:SUITE 22
Practice Address - City:MILLBURN
Practice Address - State:NJ
Practice Address - Zip Code:07041-1158
Practice Address - Country:US
Practice Address - Phone:973-864-4835
Practice Address - Fax:973-218-8434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-17
Last Update Date:2015-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05331100251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1790055069OtherTYPE 1 NPI