Provider Demographics
NPI:1942859582
Name:FRAZIER, ALEXIS (LMSW)
Entity Type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2311 WILLOUGHBY BEACH RD
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-3419
Mailing Address - Country:US
Mailing Address - Phone:410-612-1518
Mailing Address - Fax:
Practice Address - Street 1:2311 WILLOUGHBY BEACH RD
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3419
Practice Address - Country:US
Practice Address - Phone:410-612-1518
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-06
Last Update Date:2019-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD23871101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health