Healthcare Provider Details

I. General information

NPI: 1780279976
Provider Name (Legal Business Name): JAZMINE FRANKLIN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2021
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2117 BROADWAY DR.
HATTIESBURG MS
39402-3210
US

IV. Provider business mailing address

2117 BROADWAY DR
HATTIESBURG MS
39402-3210
US

V. Phone/Fax

Practice location:
  • Phone: 601-288-8050
  • Fax: 601-288-8058
Mailing address:
  • Phone: 601-288-8050
  • Fax: 601-288-8058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10725
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: