Healthcare Provider Details

I. General information

NPI: 1801251889
Provider Name (Legal Business Name): KELLI FRANKLIN MS, LPC, LCDC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/17/2015
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 S COMMERCE ST
CENTERVILLE TX
75833-1965
US

IV. Provider business mailing address

7300 BLANCO RD STE 501
SAN ANTONIO TX
78216-4941
US

V. Phone/Fax

Practice location:
  • Phone: 903-536-3697
  • Fax: 888-823-3497
Mailing address:
  • Phone: 210-446-8255
  • Fax: 888-823-3497

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number13643
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number74735
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: