Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YA0400X | Addiction Counselor (Substance Use Disorder) | LPC0000000827 | TN |
Y | 101YM0800X | Mental Health Counselor | LPC0000000827 | TN |
N | 101YP1600X | Pastoral Counselor | LPC0000000827 | TN |
N | 101YP2500X | Professional Counselor | LPC0000000827 | TN |
NPI | 1144367459 |
---|---|
Provider Name | Franklin Cardona |
First Address | Clarksville, TN 37040-6888 |
Second Address | Clarksville, TN 37040-6888 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/01/2007 |
Last Update Date | 12/01/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3133798 | BLUE CROSS BLUE SHEILD (01) | TN |
MAGELLAN | MAGELLAN (01) | TN |