Provider Demographics
NPI:1215272919
Name:JANINE DEFRANCO LCSW, PLLC
Entity type:Organization
Organization Name:JANINE DEFRANCO LCSW, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:JANINE
Authorized Official - Middle Name:E
Authorized Official - Last Name:DEFRANCO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:845-473-2175
Mailing Address - Street 1:202 HOOKER AVE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-3329
Mailing Address - Country:US
Mailing Address - Phone:845-473-2175
Mailing Address - Fax:845-463-1061
Practice Address - Street 1:202 HOOKER AVE
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-3329
Practice Address - Country:US
Practice Address - Phone:845-473-2175
Practice Address - Fax:845-463-1061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR07379311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01973660Medicaid