Provider Demographics
NPI:1417283037
Name:FRANKLIN A ROBERTS MS, PA
Entity Type:Organization
Organization Name:FRANKLIN A ROBERTS MS, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:FRANKLIN
Authorized Official - Middle Name:ARNOLD
Authorized Official - Last Name:ROBERTS
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LMHC
Authorized Official - Phone:850-301-0446
Mailing Address - Street 1:228 BROOKS ST SE
Mailing Address - Street 2:
Mailing Address - City:FORT WALTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32548-2800
Mailing Address - Country:US
Mailing Address - Phone:850-301-0446
Mailing Address - Fax:850-301-0442
Practice Address - Street 1:228 BROOKS ST SE
Practice Address - Street 2:
Practice Address - City:FORT WALTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:32548-2800
Practice Address - Country:US
Practice Address - Phone:850-301-0446
Practice Address - Fax:850-301-0442
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-02
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT1756106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty