Provider Demographics
NPI:1962974600
Name:FRANKEN, JEFFREY ALAN (LMHC)
Entity type:Individual
Prefix:
First Name:JEFFREY
Middle Name:ALAN
Last Name:FRANKEN
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 CALLE PONDEROSA
Mailing Address - Street 2:
Mailing Address - City:PLACITAS
Mailing Address - State:NM
Mailing Address - Zip Code:87043-9328
Mailing Address - Country:US
Mailing Address - Phone:505-220-9478
Mailing Address - Fax:
Practice Address - Street 1:9 CALLE PONDEROSA
Practice Address - Street 2:
Practice Address - City:PLACITAS
Practice Address - State:NM
Practice Address - Zip Code:87043-9328
Practice Address - Country:US
Practice Address - Phone:505-220-9478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCMH0198571103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling