Provider Demographics
NPI:1467132316
Name:FRALEY, ANGELINE (LMHC)
Entity Type:Individual
Prefix:
First Name:ANGELINE
Middle Name:
Last Name:FRALEY
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 COVE CAY DR UNIT 5D
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33760-1221
Mailing Address - Country:US
Mailing Address - Phone:727-266-2157
Mailing Address - Fax:
Practice Address - Street 1:1000 COVE CAY DR UNIT 5D
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33760-1221
Practice Address - Country:US
Practice Address - Phone:727-266-2157
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH22538101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health