Healthcare Provider Details

I. General information

NPI: 1316304025
Provider Name (Legal Business Name): MIKAYLA FRANKLIN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 11/14/2023
Certification Date: 11/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 KIRKMAN ST STE A
LAKE CHARLES LA
70601-5391
US

IV. Provider business mailing address

2714 TUPELO ST
LAKE CHARLES LA
70601-7376
US

V. Phone/Fax

Practice location:
  • Phone: 337-419-3586
  • Fax: 855-239-9737
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number15797
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: