1023091527 NPI number — DR. FRANKIE ANNE SMALL ED.D. ED.S. MSW LCSW

Table of content: DR. FRANKIE ANNE SMALL ED.D. ED.S. MSW LCSW (NPI 1023091527)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023091527 NPI number — DR. FRANKIE ANNE SMALL ED.D. ED.S. MSW LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMALL
Provider First Name:
FRANKIE
Provider Middle Name:
ANNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
ED.D. ED.S. MSW LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARTLEDGE SMALL
Provider Other First Name:
FRANKIE
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ED.D.ED.S.MSWLCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1023091527
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
137 S PEBBLE BEACH BLVD STE 202A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUN CITY CENTER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33573-5708
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
850-232-2148
Provider Business Mailing Address Fax Number:
813-330-3339

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
137 S PEBBLE BEACH BLVD STE 202A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUN CITY CENTER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33573-5708
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
850-232-2148
Provider Business Practice Location Address Fax Number:
813-330-3339
Provider Enumeration Date:
11/29/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  SW7578 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 015947500 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".