Provider Demographics
NPI:1851490601
Name:FRAZIER, CARL (LCSW)
Entity Type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 SAINT ANDREWS PL
Mailing Address - Street 2:APARTMENT# 4B
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10705-3154
Mailing Address - Country:US
Mailing Address - Phone:914-423-6191
Mailing Address - Fax:914-423-6191
Practice Address - Street 1:15 SAINT ANDREWS PL
Practice Address - Street 2:APARTMENT# 4B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10705-3154
Practice Address - Country:US
Practice Address - Phone:914-423-6191
Practice Address - Fax:914-423-6191
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP062269-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical