Provider Demographics
NPI:1891225678
Name:FRANCIS, PHIL EDWARD (CSW)
Entity Type:Individual
Prefix:
First Name:PHIL
Middle Name:EDWARD
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 E STRINGHAM AVE
Mailing Address - Street 2:C 121
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84109
Mailing Address - Country:US
Mailing Address - Phone:507-269-4556
Mailing Address - Fax:
Practice Address - Street 1:4000 S 700 E STE 9
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84107-2581
Practice Address - Country:US
Practice Address - Phone:801-587-3000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor