Provider Demographics
NPI:1891186102
Name:FRANCIS, KENTON (LCSW)
Entity Type:Individual
Prefix:
First Name:KENTON
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:KEN
Other - Middle Name:
Other - Last Name:FRANCIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:793 CREEKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:LAYTON
Mailing Address - State:UT
Mailing Address - Zip Code:84041-4216
Mailing Address - Country:US
Mailing Address - Phone:801-721-2899
Mailing Address - Fax:
Practice Address - Street 1:1355 NORTH MAIN STREET #1
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010
Practice Address - Country:US
Practice Address - Phone:801-721-2899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-09
Last Update Date:2015-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6159222-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical