Provider Demographics
NPI:1760656565
Name:FRAZIER, STEVEN LOREN (LCPC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:LOREN
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:708 W BITTERSWEET PL
Mailing Address - Street 2:#102
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-2356
Mailing Address - Country:US
Mailing Address - Phone:773-988-3729
Mailing Address - Fax:
Practice Address - Street 1:6984 12TH TER N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-6126
Practice Address - Country:US
Practice Address - Phone:773-357-5523
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-14
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180003643101YP2500X
TX711980103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchoolGroup - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional