Provider Demographics
NPI:1720784655
Name:SAMPSON, FRANKIE MICHELLE
Entity type:Individual
Prefix:MS
First Name:FRANKIE
Middle Name:MICHELLE
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:FRANKIE
Other - Middle Name:MICHELLE
Other - Last Name:SAMPSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW, CASAC
Mailing Address - Street 1:595 BROWN STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14611
Mailing Address - Country:US
Mailing Address - Phone:585-746-5889
Mailing Address - Fax:
Practice Address - Street 1:595 BROWN STREET
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611
Practice Address - Country:US
Practice Address - Phone:585-746-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2024-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY31957101YA0400X
NY118754104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)