Provider Demographics
NPI:1417495029
Name:SUSAN D. FRASER, MSW, LCADC, LCSW, L.L.C
Entity Type:Organization
Organization Name:SUSAN D. FRASER, MSW, LCADC, LCSW, L.L.C
Other - Org Name:CYPRESS COUNSELING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCADC, LCSW
Authorized Official - Phone:732-451-7668
Mailing Address - Street 1:PO BOX 1826
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-1068
Mailing Address - Country:US
Mailing Address - Phone:732-451-7668
Mailing Address - Fax:888-972-4834
Practice Address - Street 1:524 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-1561
Practice Address - Country:US
Practice Address - Phone:732-684-8763
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-02
Last Update Date:2018-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty