Provider Demographics
NPI:1700634540
Name:FRANKLIN, MARISSA MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:MARISSA
Middle Name:MARIE
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1065 JADE DR
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-3311
Mailing Address - Country:US
Mailing Address - Phone:515-778-8008
Mailing Address - Fax:
Practice Address - Street 1:666 WALNUT ST STE 1610
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50309-3974
Practice Address - Country:US
Practice Address - Phone:515-369-0034
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-07
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA1236181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical