Provider Demographics
NPI:1790830057
Name:FRAIN, JOHN G (MA, LPC)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:G
Last Name:FRAIN
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1911 KANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:MCKEESPORT
Mailing Address - State:PA
Mailing Address - Zip Code:15131-2303
Mailing Address - Country:US
Mailing Address - Phone:412-664-4605
Mailing Address - Fax:
Practice Address - Street 1:1705 MAPLE ST
Practice Address - Street 2:ROOM #1
Practice Address - City:HOMESTEAD
Practice Address - State:PA
Practice Address - Zip Code:15120-1800
Practice Address - Country:US
Practice Address - Phone:412-464-4781
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC0003260101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA782119000OtherMAGELLAN
PAXOtherUNITED BEHAVIORAL HEALTH
PA1659676OtherHIGHMARK
PA376902OtherMHN TRICARE CHAMPUS
PA782119000OtherMAGELLAN