Provider Demographics
NPI:1144367459
Name:CARDONA, FRANKLIN (LPC,CAS,MDIV,CSATPHD)
Entity type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:
Last Name:CARDONA
Suffix:
Gender:M
Credentials:LPC,CAS,MDIV,CSATPHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2219 LOWES DR W
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-6888
Mailing Address - Country:US
Mailing Address - Phone:931-553-6981
Mailing Address - Fax:931-553-6982
Practice Address - Street 1:2219 LOWES DR W
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-6888
Practice Address - Country:US
Practice Address - Phone:931-553-6981
Practice Address - Fax:931-553-6082
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2018-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000000827101YA0400X, 101YP1600X, 101YP2500X, 106H00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNMAGELLANOtherMAGELLAN
TN3133798OtherBLUE CROSS BLUE SHEILD