Provider Demographics
NPI:1548518772
Name:PINKHAM, FRANKLIN CHARLES (LLMSW, BCBA)
Entity type:Individual
Prefix:MR
First Name:FRANKLIN
Middle Name:CHARLES
Last Name:PINKHAM
Suffix:
Gender:M
Credentials:LLMSW, BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32101 CHICAGO ROAD
Mailing Address - Street 2:302
Mailing Address - City:WARREN
Mailing Address - State:MI
Mailing Address - Zip Code:48093
Mailing Address - Country:US
Mailing Address - Phone:586-999-5971
Mailing Address - Fax:
Practice Address - Street 1:31201 CHICAGO RD S
Practice Address - Street 2:302
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-5527
Practice Address - Country:US
Practice Address - Phone:586-999-5971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-20
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1-15-18747103K00000X
MI6801094670104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No104100000XBehavioral Health & Social Service ProvidersSocial Worker