Provider Demographics
NPI:1851507560
Name:FRAZIER, BETTY MIKAL (LMFT, LPC)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:MIKAL
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LMFT, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:208 BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:LA
Mailing Address - Zip Code:71055-3301
Mailing Address - Country:US
Mailing Address - Phone:318-377-0182
Mailing Address - Fax:318-377-7617
Practice Address - Street 1:208 BROADWAY ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:LA
Practice Address - Zip Code:71055-3301
Practice Address - Country:US
Practice Address - Phone:318-377-0182
Practice Address - Fax:318-377-7617
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1699101YP2500X
LA259106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist