Francine M Licata
Individual provider Active NPI Counselor · Lee, MA
NPI 1962775262 · NPPES record last updated Feb 20, 2019
Key facts
- NPI
- 1962775262
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 114559 (MA)
- Practice address
- 11 Quarry Hill Road
Lee, MA 01238 - Phone
- (413) 243-0536
- Fax
- (413) 243-8040
- NPI assigned
- Feb 16, 2012
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
2 Quiet Knoll Rd
Stockbridge, MA 01262-7752
Phone (347) 721-8591
PO Box
Suite 1552
Stockbridge, MA 01262-1552
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20140626000767 | MA | Practitioner - Clinical Social Worker | 2668697137 |
Reassigns benefits to 1 organization Practice locations: Stockbridge, MA |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Community Health Programs, Inc. | Current |
Accepting new patients |
Locations
11 Quarry Hill Rd
Lee, MA 01238
Phone (413) 243-0536
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 114559 | MA | Yes |
| Counselor | 101Y00000X |
Addresses
Primary practice location
11 Quarry Hill Road
Lee, MA 01238
Mailing address
P.O. Box 30
Great Barrington, MA 01230
Phone (413) 528-9311
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 110109519A | Medicaid | MA |
Other providers in Lee, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 20, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.