Provider Demographics
NPI:1467587147
Name:LAFRAZIA, TERRY A (LCSW)
Entity Type:Individual
Prefix:
First Name:TERRY
Middle Name:A
Last Name:LAFRAZIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 WARREN ST APT 2A
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-2730
Mailing Address - Country:US
Mailing Address - Phone:347-693-1379
Mailing Address - Fax:
Practice Address - Street 1:435 W 23RD ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-1402
Practice Address - Country:US
Practice Address - Phone:347-693-1379
Practice Address - Fax:212-691-1169
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0732401041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical