Provider Demographics
NPI:1114142379
Name:CHARLES, FRANKIE J
Entity Type:Individual
Prefix:
First Name:FRANKIE
Middle Name:J
Last Name:CHARLES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FRANKIE
Other - Middle Name:J
Other - Last Name:CHARLES
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHP
Mailing Address - Street 1:6663 SORENSEN PKWY
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68152-2139
Mailing Address - Country:US
Mailing Address - Phone:402-502-9788
Mailing Address - Fax:402-453-6768
Practice Address - Street 1:6663 SORENSEN PKWY
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68152-2139
Practice Address - Country:US
Practice Address - Phone:402-502-9788
Practice Address - Fax:402-453-6768
Is Sole Proprietor?:No
Enumeration Date:2007-04-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE2290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health