Healthcare Provider Details

I. General information

NPI: 1588753537
Provider Name (Legal Business Name): FRANKLIN ABBOTT L.C.S.W.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1904 MONROE DR NE SUITE 120
ATLANTA GA
30324-4858
US

IV. Provider business mailing address

1904 MONROE DR NE SUITE 120
ATLANTA GA
30324-4858
US

V. Phone/Fax

Practice location:
  • Phone: 404-874-8294
  • Fax: 404-874-2020
Mailing address:
  • Phone: 404-874-8294
  • Fax: 404-874-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW001485
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: