Provider Demographics
NPI:1164281457
Name:FRANKLIN, JACOB (MFT-I)
Entity Type:Individual
Prefix:
First Name:JACOB
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:MFT-I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:130 ACORN OAKS CIR APT 238
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37405-2166
Mailing Address - Country:US
Mailing Address - Phone:423-596-7465
Mailing Address - Fax:
Practice Address - Street 1:600 GEORGIA AVE STE 1-E
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37402-1407
Practice Address - Country:US
Practice Address - Phone:423-596-7465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-18
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2330106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist