Provider Demographics
NPI:1780124941
Name:CATHLEEN FRANKLIN LLC
Entity type:Organization
Organization Name:CATHLEEN FRANKLIN LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:CATHLEEN
Authorized Official - Middle Name:M
Authorized Official - Last Name:FRANKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:269-343-6420
Mailing Address - Street 1:4230 S WESTNEDGE AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49008-3291
Mailing Address - Country:US
Mailing Address - Phone:269-343-6420
Mailing Address - Fax:269-343-6430
Practice Address - Street 1:4230 S WESTNEDGE AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49008-3291
Practice Address - Country:US
Practice Address - Phone:269-343-6420
Practice Address - Fax:269-343-6430
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-07
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010799461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIP89166Medicare UPIN