Provider Demographics
NPI:1508547670
Name:WENDY FRAYER, LCSW
Entity Type:Organization
Organization Name:WENDY FRAYER, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:LYNNE
Authorized Official - Last Name:FRAYER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:207-699-8046
Mailing Address - Street 1:10 GRACELAWN RD APT 109
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04210-6556
Mailing Address - Country:US
Mailing Address - Phone:207-699-8046
Mailing Address - Fax:207-344-6177
Practice Address - Street 1:10 GRACELAWN RD APT 109
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:ME
Practice Address - Zip Code:04210-6556
Practice Address - Country:US
Practice Address - Phone:207-699-8046
Practice Address - Fax:207-344-6177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-31
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health