Basic Information
| Provider Information | |||||||||
| NPI: | 1023216108 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LESICKO | ||||||||
| FirstName: | FRANCES | ||||||||
| MiddleName: | NELSON | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.A. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2021 E HENNEPIN AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554132700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6513894680 | ||||||||
| FaxNumber: | 6513894691 | ||||||||
| Practice Location | |||||||||
| Address1: | 2021 E HENNEPIN AVE | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554132700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6513894680 | ||||||||
| FaxNumber: | 6513894691 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103TC0700X | LP3006 | MN | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
No ID Information.