Provider Demographics
NPI:1447930441
Name:FRANCIS, BRIAN C (CSAC)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:C
Last Name:FRANCIS
Suffix:
Gender:M
Credentials:CSAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 DERONDA ST
Mailing Address - Street 2:
Mailing Address - City:AMERY
Mailing Address - State:WI
Mailing Address - Zip Code:54001-1412
Mailing Address - Country:US
Mailing Address - Phone:715-268-0136
Mailing Address - Fax:715-268-0061
Practice Address - Street 1:230 DERONDA ST
Practice Address - Street 2:
Practice Address - City:AMERY
Practice Address - State:WI
Practice Address - Zip Code:54001-1412
Practice Address - Country:US
Practice Address - Phone:715-268-0136
Practice Address - Fax:715-268-0061
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI16275-132101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)