Provider Demographics
NPI:1386074912
Name:FRANKLIN, ASHLEY NEALE BULLARD (LPC)
Entity type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NEALE BULLARD
Last Name:FRANKLIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:NEALE
Other - Last Name:BULLARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1640 LELIA DR STE 140
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216-4832
Mailing Address - Country:US
Mailing Address - Phone:601-706-9611
Mailing Address - Fax:601-724-5165
Practice Address - Street 1:1640 LELIA DR STE 140
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4832
Practice Address - Country:US
Practice Address - Phone:601-706-9611
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-18
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67560101YP2500X
MS1827101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00018209Medicaid