Provider Demographics
NPI:1245567270
Name:FRANKLIN, GINA (MSW,LCAS)
Entity Type:Individual
Prefix:
First Name:GINA
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MSW,LCAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:806 W HOWARD AVE
Mailing Address - Street 2:
Mailing Address - City:TARBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27886-3612
Mailing Address - Country:US
Mailing Address - Phone:252-752-5555
Mailing Address - Fax:
Practice Address - Street 1:108 W FIRE TOWER RD
Practice Address - Street 2:SUITE F
Practice Address - City:WINTERVILLE
Practice Address - State:NC
Practice Address - Zip Code:28590-8371
Practice Address - Country:US
Practice Address - Phone:252-752-5555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-12
Last Update Date:2009-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1266101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)