Defrancesco, Tom A
Defrancesco, Tom A is an individual health care provider with primary practice located at 4810 Northwestern Ave , Racine WI 53406-1504. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Defrancesco, Tom A can be contacted via phone (262) 637-9984.Contact Information
Primary practice address
4810 Northwestern Ave
Racine WI 53406-1504
Phone: (262) 637-9984
Fax: (262) 637-9995
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 11971 | Wisconsin |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 1166-123 | Wisconsin |
Profile Details
| NPI number | 1053453381 |
|---|---|
| LBN Legal business name | Defrancesco, Tom A |
| Credentials | LCSW, CADC |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 13th, 2007 |
| Last updated | Sep 23rd, 2010 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053453381 | NPPES |
| Wisconsin | MEDICAID | 39549500 |
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