Provider Demographics
NPI:1356675821
Name:FREAR, VIVIAN T (LPC)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:T
Last Name:FREAR
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:311 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19901-6729
Mailing Address - Country:US
Mailing Address - Phone:302-632-7424
Mailing Address - Fax:302-698-3936
Practice Address - Street 1:311 S STATE ST
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19901-6729
Practice Address - Country:US
Practice Address - Phone:302-632-7424
Practice Address - Fax:302-698-3936
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEPC-0000467101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional