Provider Demographics
NPI:1063004240
Name:FRAZIER-BEAR, SUE (MS/LPC,MHSP,S)
Entity Type:Individual
Prefix:
First Name:SUE
Middle Name:
Last Name:FRAZIER-BEAR
Suffix:
Gender:F
Credentials:MS/LPC,MHSP,S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N CHEROKEE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:JONESBOROUGH
Mailing Address - State:TN
Mailing Address - Zip Code:37659-5599
Mailing Address - Country:US
Mailing Address - Phone:423-262-0180
Mailing Address - Fax:423-262-0181
Practice Address - Street 1:501 N CHEROKEE ST STE 2
Practice Address - Street 2:
Practice Address - City:JONESBOROUGH
Practice Address - State:TN
Practice Address - Zip Code:37659-5599
Practice Address - Country:US
Practice Address - Phone:423-262-0180
Practice Address - Fax:423-262-0181
Is Sole Proprietor?:No
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLPC0000001842101Y00000X, 101YA0400X, 101YP2500X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional