Provider Demographics
NPI:1588130355
Name:FRANCIS, SHADEEN (LMFT)
Entity type:Individual
Prefix:
First Name:SHADEEN
Middle Name:
Last Name:FRANCIS
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6703 GERMANTOWN AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19119-2109
Mailing Address - Country:US
Mailing Address - Phone:215-606-3414
Mailing Address - Fax:
Practice Address - Street 1:6703 GERMANTOWN AVE STE 200
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2109
Practice Address - Country:US
Practice Address - Phone:215-606-3414
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-19
Last Update Date:2018-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMF001029106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist