Provider Demographics
NPI:1164222402
Name:MENDENHALL, FRANCESCA BLAKE
Entity type:Individual
Prefix:
First Name:FRANCESCA
Middle Name:BLAKE
Last Name:MENDENHALL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 DUPONT ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19127-1208
Mailing Address - Country:US
Mailing Address - Phone:484-624-9591
Mailing Address - Fax:
Practice Address - Street 1:4931 WISSAHICKON AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4800
Practice Address - Country:US
Practice Address - Phone:215-385-5122
Practice Address - Fax:267-787-1148
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-17
Last Update Date:2025-08-13
Deactivation Date:2025-07-19
Deactivation Code:
Reactivation Date:2025-08-13
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist