Provider Demographics
NPI:1609296920
Name:FRANKLIN, CYNTHIA DONISE (MBA, CPSS, SAS)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:DONISE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MBA, CPSS, SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 CAROUSEL CIR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29203-6367
Mailing Address - Country:US
Mailing Address - Phone:803-445-9038
Mailing Address - Fax:803-726-9485
Practice Address - Street 1:2711 COLONIAL DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29203-6818
Practice Address - Country:US
Practice Address - Phone:803-726-9357
Practice Address - Fax:803-726-9485
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2014-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)