Provider Demographics
NPI:1598790289
Name:FRAWLEY, JACQUELINE R (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JACQUELINE
Middle Name:R
Last Name:FRAWLEY
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 1:1777 TAMIAMI TRL
Mailing Address - Street 2:STE 201
Mailing Address - City:PORT CHARLOTTE
Mailing Address - State:FL
Mailing Address - Zip Code:33948-1064
Mailing Address - Country:US
Mailing Address - Phone:941-249-4354
Mailing Address - Fax:941-249-4356
Practice Address - Street 1:1777 TAMIAMI TRL
Practice Address - Street 2:SUITE 400
Practice Address - City:PORT CHARLOTTE
Practice Address - State:FL
Practice Address - Zip Code:33948-1078
Practice Address - Country:US
Practice Address - Phone:941-249-4354
Practice Address - Fax:941-249-4356
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2016-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW00019881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical