Provider Demographics
NPI:1245584242
Name:FRASER-SOLAK, FELICIDAD XYLIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:FELICIDAD
Middle Name:XYLIA
Last Name:FRASER-SOLAK
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 W 120TH AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:WESTMINSTER
Mailing Address - State:CO
Mailing Address - Zip Code:80234-2479
Mailing Address - Country:US
Mailing Address - Phone:720-629-9441
Mailing Address - Fax:720-836-4204
Practice Address - Street 1:2010 W 120TH AVE STE 201
Practice Address - Street 2:
Practice Address - City:WESTMINSTER
Practice Address - State:CO
Practice Address - Zip Code:80234-2479
Practice Address - Country:US
Practice Address - Phone:720-629-9441
Practice Address - Fax:720-836-4204
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-30
Last Update Date:2020-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1209831041S0200X
COCSW.099239841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO13548875OtherCAQH
CO08750050Medicaid