Provider Demographics
NPI:1497290605
Name:FRANKLIN, PAULA S (LCPC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:S
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SAUK TRL
Mailing Address - Street 2:
Mailing Address - City:PARK FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60466-2025
Mailing Address - Country:US
Mailing Address - Phone:708-949-2967
Mailing Address - Fax:
Practice Address - Street 1:125 SAUK TRL
Practice Address - Street 2:
Practice Address - City:PARK FOREST
Practice Address - State:IL
Practice Address - Zip Code:60466-2025
Practice Address - Country:US
Practice Address - Phone:708-949-2967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-23
Last Update Date:2016-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.006881101YP2500X
ILMRAS F1612011409101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)