=====================================================
General NPI Number Information
=====================================================
NPI Number | 1699428532
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CARLEN FRANKLIN LMSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/01/2022
-----------------------------------------------------
Last Update Date | 02/01/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5775 GLENRIDGE DR BLDG B
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30328-5380
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 770-674-8287
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4886 WEDGEWOOD WAY
-----------------------------------------------------
City | STONE MOUNTAIN
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30088-3920
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-626-3048
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | MSW009520
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------