MEDICARE: LISA FRANKLIN LMHC COACHING AND COUNSELING SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1902362262
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LISA FRANKLIN LMHC COACHING AND COUNSELING SERVICES LLC

Provider Business Mailing Address
First Line	:	2146 W RAILROAD AVE
Second Line	:
City	:	SHELTON
State	:	WA
Zip	:	98584-7126
Country	:	US
Telephone Number	:	360-790-8720
Fax Number	:

Provider Business Practice Location Address
First Line	:	2146 W RAILROAD AVE
Second Line	:
City	:	SHELTON
State	:	WA
Zip	:	98584-7126
Country	:	US
Telephone Number	:	360-790-8720
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	LISA FRANKLIN
Credential	:	LMHC
Telephone Number	:	360-790-8720

Provider Enumeration Date	:	02/12/2019
Last Update Date	:	02/12/2019

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