Provider Demographics
NPI:1033789623
Name:FRASURE, CHERYL MARIE (BSW, MSW)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:MARIE
Last Name:FRASURE
Suffix:
Gender:F
Credentials:BSW, MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:464 EAGLE TRACE BLVD
Mailing Address - Street 2:
Mailing Address - City:HAROLD
Mailing Address - State:KY
Mailing Address - Zip Code:41635-8715
Mailing Address - Country:US
Mailing Address - Phone:606-205-5093
Mailing Address - Fax:
Practice Address - Street 1:173 REDALE RD
Practice Address - Street 2:
Practice Address - City:PIKEVILLE
Practice Address - State:KY
Practice Address - Zip Code:41501-9072
Practice Address - Country:US
Practice Address - Phone:606-432-9442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty