Provider Demographics
NPI:1487212916
Name:IACOBUCCI, FRANCIS REGINALD III (MSW)
Entity type:Individual
Prefix:MR
First Name:FRANCIS
Middle Name:REGINALD
Last Name:IACOBUCCI
Suffix:III
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1203 N 3RD ST APT 206
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19122-4405
Mailing Address - Country:US
Mailing Address - Phone:484-437-1163
Mailing Address - Fax:
Practice Address - Street 1:1734 MARYLAND AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-5804
Practice Address - Country:US
Practice Address - Phone:877-674-3843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-30
Last Update Date:2019-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical