Provider Demographics
NPI:1396977971
Name:BAX, FRANCIS ANTHONY (LMHC)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:ANTHONY
Last Name:BAX
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 ROBINSON STREET
Mailing Address - Street 2:LOWER APARTMENT
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-6927
Mailing Address - Country:US
Mailing Address - Phone:716-622-3600
Mailing Address - Fax:
Practice Address - Street 1:203 ROBINSON STREET
Practice Address - Street 2:LOWER APARTMENT
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120
Practice Address - Country:US
Practice Address - Phone:716-476-4244
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-17
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31830101YA0400X
NVCP5004-R101YM0800X
NY003797101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCP5004-ROtherNEVADA LICENSED PROFESSIONAL COUNSELOR
NY003797-1OtherLICENSED MENTAL HEALTH COUNSELOR