Mario Gibson Franciscotty, LLPC
Individual provider Active NPI Counselor · Ada, MI
NPI 1831556091 · NPPES record last updated Mar 3, 2016
Key facts
- NPI
- 1831556091
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 6401010137 (MI)
- Practice address
- 6200 Egypt Valley CT NE
Ada, MI 49301-9660 - Phone
- (616) 295-0691
- NPI assigned
- Jan 19, 2016
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401010137 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Creda PLLC | Current | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401010137 | MI | Yes |
Addresses
Primary practice location
6200 Egypt Valley CT NE
Ada, MI 49301-9660
Mailing address
6200 Egypt Valley CT NE
Ada, MI 49301-9660
Phone (616) 295-0691
Other providers in Ada, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 3, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.