Provider Demographics
NPI:1811504889
Name:FRANCIS, MARY KATE (LPC)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:KATE
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:MARY
Other - Middle Name:KATE
Other - Last Name:BLEVINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:2 BUCKINGHAM PL APT A
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-1198
Mailing Address - Country:US
Mailing Address - Phone:404-317-4567
Mailing Address - Fax:
Practice Address - Street 1:12166 OLD BIG BEND RD
Practice Address - Street 2:
Practice Address - City:KIRKWOOD
Practice Address - State:MO
Practice Address - Zip Code:63122-6844
Practice Address - Country:US
Practice Address - Phone:314-822-8888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020039192101YP2500X
VA0701009679101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional