Individual provider Active NPI

Ellery Kent Franklin, LCSW

  • Clinical Social Worker
  • Charlotte, NC
National Provider Identifier
1043797574
Registry record updated Nov 6, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C013434 Issued in NC
Practice address
769 N Wendover Rd
Charlotte, NC 28211-1118
Phone
(704) 376-7180
NPI assigned
Jul 27, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X C013434 NC Primary

Addresses

Primary practice location

769 N Wendover Rd
Charlotte, NC 28211-1118

Mailing address

5349 Coburg Ave
Charlotte, NC 28215-2201
Phone (704) 635-5597

Other practice location 1

5349 Coburg Ave
Charlotte, NC 28215
Phone (704) 635-5597

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
C013434NCMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1532649600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604620800000",
    "number": "1043797574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5349 COBURG AVE",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282152201",
            "telephone_number": "704-635-5597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "769 N WENDOVER RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111118",
            "telephone_number": "704-376-7180"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5349 Coburg Ave",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "28215",
            "country_code": "US",
            "telephone_number": "704-635-5597",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRANKLIN",
        "first_name": "ELLERY",
        "middle_name": "KENT",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-27",
        "last_updated": "2020-11-06",
        "certification_date": "2020-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C013434",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.