Provider Demographics
NPI:1598192585
Name:FRAZIER, NICOLE KATHLEEN (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:KATHLEEN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:659 G ST NORTH EAST
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20002
Mailing Address - Country:US
Mailing Address - Phone:202-698-3244
Mailing Address - Fax:
Practice Address - Street 1:659 G ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-4305
Practice Address - Country:US
Practice Address - Phone:202-698-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-04
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500777481041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool