Provider Demographics
NPI:1477330942
Name:FRANKLIN, MARY MASOMEH (LCSW)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:MASOMEH
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:MASOMEH
Other - Last Name:JONAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:220 SIMMONS DR
Mailing Address - Street 2:
Mailing Address - City:CEDAR PARK
Mailing Address - State:TX
Mailing Address - Zip Code:78613-4577
Mailing Address - Country:US
Mailing Address - Phone:850-530-0617
Mailing Address - Fax:
Practice Address - Street 1:220 SIMMONS DR
Practice Address - Street 2:
Practice Address - City:CEDAR PARK
Practice Address - State:TX
Practice Address - Zip Code:78613-4577
Practice Address - Country:US
Practice Address - Phone:850-530-0617
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
225C00000X
FLSW167911041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No225C00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Counselor