Provider Demographics
NPI:1306959085
Name:MARKOVER, FRAN (LCSW)
Entity type:Individual
Prefix:MS
First Name:FRAN
Middle Name:
Last Name:MARKOVER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 N TIOGA STREET
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-4205
Mailing Address - Country:US
Mailing Address - Phone:607-272-8837
Mailing Address - Fax:
Practice Address - Street 1:319 N TIOGA STREET
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-4205
Practice Address - Country:US
Practice Address - Phone:607-272-8837
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCASAC 1719101YA0400X
003449101YA0400X
NYLCSW R 0285741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
4258521OtherAETNA
787073OtherMVP HEALTH CARE
7403403003OtherVALUE OPTIONS/GH1
132839OtherVALUE OPTIONS
000914233001OtherHEALTH NOW
54953BMedicare ID - Type Unspecified