Provider Demographics
NPI:1801976394
Name:FRANCIS, DAVID L (LPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 NEW LONDON TPKE
Mailing Address - Street 2:SUITE 320
Mailing Address - City:GLASTONBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06033-2061
Mailing Address - Country:US
Mailing Address - Phone:860-633-2084
Mailing Address - Fax:860-633-5452
Practice Address - Street 1:39 NEW LONDON TPKE
Practice Address - Street 2:SUITE 320
Practice Address - City:GLASTONBURY
Practice Address - State:CT
Practice Address - Zip Code:06033-2061
Practice Address - Country:US
Practice Address - Phone:860-633-2084
Practice Address - Fax:860-633-5452
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001145101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
205816OtherMHN
CT300000112CT01OtherBLUE CROSS