Provider Demographics
NPI:1932200920
Name:SKINNER-DEFRANCISCO, SYLVIA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:
Last Name:SKINNER-DEFRANCISCO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6321 OLD COUNTY RD
Mailing Address - Street 2:
Mailing Address - City:CANASTOTA
Mailing Address - State:NY
Mailing Address - Zip Code:13032-4173
Mailing Address - Country:US
Mailing Address - Phone:315-697-8953
Mailing Address - Fax:
Practice Address - Street 1:6321 OLD COUNTY RD
Practice Address - Street 2:
Practice Address - City:CANASTOTA
Practice Address - State:NY
Practice Address - Zip Code:13032-4173
Practice Address - Country:US
Practice Address - Phone:315-697-8953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY29669-R1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP70731Medicare UPIN
NYDD2862Medicare ID - Type Unspecified