Provider Demographics
NPI:1174646475
Name:FRAUENS, ANNE MAGILL (LCSW)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MAGILL
Last Name:FRAUENS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:M
Other - Last Name:FRAUENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:423 DEER TRAIL HL
Mailing Address - Street 2:
Mailing Address - City:LAKE BARRINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:60010-1703
Mailing Address - Country:US
Mailing Address - Phone:910-540-4199
Mailing Address - Fax:
Practice Address - Street 1:423 DEER TRAIL HL
Practice Address - Street 2:
Practice Address - City:LAKE BARRINGTON
Practice Address - State:IL
Practice Address - Zip Code:60010-1703
Practice Address - Country:US
Practice Address - Phone:910-540-4199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2023-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HILCSW-3018104100000X
NCC0092001041C0700X
SC123091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00B0221057OtherHMSA 65C PLUS
HI00221057OtherHMSA
HI00B0221057OtherTRICARE PROVIDER NUMBER
HI00B0221057OtherQUEST PROVIDER NUMBER
HI00B0221057OtherHMSA PROVIDER NUMBER
HI00B0221057OtherHMSA PPO
HI499328Medicaid
HI00B0221057OtherHMSA 65C PLUS