Provider Demographics
NPI:1316083033
Name:FRANCES, DIANNE M (LPC)
Entity type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:M
Last Name:FRANCES
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:DIANNE
Other - Middle Name:M
Other - Last Name:FRANCES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:13035 W BLUEMOUND RD STE 205
Mailing Address - Street 2:
Mailing Address - City:BROOKFIELD
Mailing Address - State:WI
Mailing Address - Zip Code:53005-8001
Mailing Address - Country:US
Mailing Address - Phone:414-278-1201
Mailing Address - Fax:414-755-7678
Practice Address - Street 1:13035 W BLUEMOUND RD STE 205
Practice Address - Street 2:
Practice Address - City:BROOKFIELD
Practice Address - State:WI
Practice Address - Zip Code:53005-8001
Practice Address - Country:US
Practice Address - Phone:414-278-1201
Practice Address - Fax:414-755-7678
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI3454-125101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI40968700Medicaid
WI42238800Medicaid