Provider Demographics
NPI:1407109648
Name:RASO, FRANDY SUZANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:FRANDY
Middle Name:SUZANNE
Last Name:RASO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:FRANDY
Other - Middle Name:SUZANNE
Other - Last Name:BARENFELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8600 ROUTE 91 NORTH, SUITE 240
Mailing Address - Street 2:
Mailing Address - City:PEORIA
Mailing Address - State:IL
Mailing Address - Zip Code:61615-9506
Mailing Address - Country:US
Mailing Address - Phone:309-683-5006
Mailing Address - Fax:309-683-5095
Practice Address - Street 1:8600 ROUTE 91 NORTH, SUITE 240
Practice Address - Street 2:
Practice Address - City:PEORIA
Practice Address - State:IL
Practice Address - Zip Code:61615-9506
Practice Address - Country:US
Practice Address - Phone:309-683-5006
Practice Address - Fax:309-683-5095
Is Sole Proprietor?:No
Enumeration Date:2012-10-25
Last Update Date:2012-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1490061781041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical