Healthcare Provider Details

I. General information

NPI: 1902749724
Provider Name (Legal Business Name): FRANKLIN MCCOLLUM LPC-A, AADC-IP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2026
Last Update Date: 04/14/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1297 PROFESSIONAL DR STE 101
MYRTLE BEACH SC
29577-5713
US

IV. Provider business mailing address

1297 PROFESSIONAL DR STE 101
MYRTLE BEACH SC
29577-5713
US

V. Phone/Fax

Practice location:
  • Phone: 843-448-4820
  • Fax: 843-448-9875
Mailing address:
  • Phone: 843-448-4820
  • Fax: 843-448-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10780
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: