Provider Demographics
NPI:1801251889
Name:FRANKLIN, KELLI (MS, LPC, LCDC)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:MS, LPC, LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7300 BLANCO RD STE 501
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78216-4941
Mailing Address - Country:US
Mailing Address - Phone:210-446-8255
Mailing Address - Fax:888-823-3497
Practice Address - Street 1:205 S COMMERCE ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:TX
Practice Address - Zip Code:75833-1965
Practice Address - Country:US
Practice Address - Phone:903-536-3697
Practice Address - Fax:888-823-3497
Is Sole Proprietor?:Yes
Enumeration Date:2015-12-17
Last Update Date:2019-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX13643101YA0400X
TX74735101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX3949968Medicaid