Provider Demographics
NPI:1346584570
Name:FRANKLIN, JASON
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1307 11TH ST
Mailing Address - Street 2:
Mailing Address - City:ROCK ISLAND
Mailing Address - State:IL
Mailing Address - Zip Code:61201-3406
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2028 E 38TH ST
Practice Address - Street 2:SUITE 3
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-1168
Practice Address - Country:US
Practice Address - Phone:563-424-2016
Practice Address - Fax:563-424-2017
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health