Provider Demographics
NPI:1700558905
Name:FRANKLIN, GARCELLE BREANNA
Entity Type:Individual
Prefix:
First Name:GARCELLE
Middle Name:BREANNA
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10190 BANNOCK ST STE 120
Mailing Address - Street 2:
Mailing Address - City:NORTHGLENN
Mailing Address - State:CO
Mailing Address - Zip Code:80260-6052
Mailing Address - Country:US
Mailing Address - Phone:803-312-5539
Mailing Address - Fax:
Practice Address - Street 1:1540 SHERIDAN BLVD APT 202
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80214-3042
Practice Address - Country:US
Practice Address - Phone:803-312-5538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC89161995Medicaid