Provider Demographics
NPI:1376892885
Name:FINE, CEVONNA FRAZIER (LCSWA)
Entity Type:Individual
Prefix:MS
First Name:CEVONNA
Middle Name:FRAZIER
Last Name:FINE
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:MS
Other - First Name:CEVONNA
Other - Middle Name:MARIE
Other - Last Name:FRAZIER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MSW
Mailing Address - Street 1:PO BOX 444
Mailing Address - Street 2:
Mailing Address - City:MURPHY
Mailing Address - State:NC
Mailing Address - Zip Code:28906-0444
Mailing Address - Country:US
Mailing Address - Phone:828-837-0071
Mailing Address - Fax:
Practice Address - Street 1:750 US HIGHWAY 64 WEST
Practice Address - Street 2:
Practice Address - City:MURPHY
Practice Address - State:NC
Practice Address - Zip Code:28906
Practice Address - Country:US
Practice Address - Phone:828-837-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-30
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0075681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical