Provider Demographics
NPI:1649576752
Name:FRASER, HEATHER ANNE (LCSW)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:ANNE
Last Name:FRASER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:HEATHER
Other - Middle Name:ANNE
Other - Last Name:EBEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASW
Mailing Address - Street 1:208 COUNTY ROAD 4886
Mailing Address - Street 2:
Mailing Address - City:SPRINGTOWN
Mailing Address - State:TX
Mailing Address - Zip Code:76082-3831
Mailing Address - Country:US
Mailing Address - Phone:909-810-3971
Mailing Address - Fax:
Practice Address - Street 1:119 N MAIN ST STE 219
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:TX
Practice Address - Zip Code:76086-3257
Practice Address - Country:US
Practice Address - Phone:909-810-3971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-07
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS179871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical