Provider Demographics
NPI:1245703867
Name:WELCH, FRANCES CHARLOTTE
Entity type:Individual
Prefix:
First Name:FRANCES
Middle Name:CHARLOTTE
Last Name:WELCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 27TH AVE APT 4A
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11102-3875
Mailing Address - Country:US
Mailing Address - Phone:347-527-1041
Mailing Address - Fax:
Practice Address - Street 1:1420 27TH AVE APT 4A
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-3875
Practice Address - Country:US
Practice Address - Phone:347-527-1041
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)