Provider Demographics
NPI:1447408166
Name:SHOEMAKER, FRANKLIN EDWARD (PHD, LMHC)
Entity Type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:EDWARD
Last Name:SHOEMAKER
Suffix:
Gender:M
Credentials:PHD, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4404 S FLORIDA AVE STE 6B
Mailing Address - Street 2:
Mailing Address - City:LAKELAND
Mailing Address - State:FL
Mailing Address - Zip Code:33813-2124
Mailing Address - Country:US
Mailing Address - Phone:863-583-4766
Mailing Address - Fax:850-270-6733
Practice Address - Street 1:4404 S FLORIDA AVE STE 14
Practice Address - Street 2:
Practice Address - City:LAKELAND
Practice Address - State:FL
Practice Address - Zip Code:33813-2124
Practice Address - Country:US
Practice Address - Phone:863-583-4766
Practice Address - Fax:850-270-6733
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-05
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH13244101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL101349300Medicaid
FLMH13244OtherFLORIDA BOARD OF CLINICAL SOCIAL WORK, MARRIAGE & FAMILY THERAPY MENTAL HEALTH