Provider Demographics
NPI:1225797988
Name:FRAZIER, KENYA J (LMFT)
Entity Type:Individual
Prefix:
First Name:KENYA
Middle Name:J
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7076 ASPEN GROVE CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40241-2522
Mailing Address - Country:US
Mailing Address - Phone:502-794-8763
Mailing Address - Fax:
Practice Address - Street 1:4229 BARDSTOWN RD STE 204
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-4271
Practice Address - Country:US
Practice Address - Phone:502-936-6546
Practice Address - Fax:502-242-1984
Is Sole Proprietor?:No
Enumeration Date:2021-12-09
Last Update Date:2021-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY274079106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist