Provider Demographics
NPI:1962447102
Name:FRASIER, KEM DENICE (LPC/I)
Entity Type:Individual
Prefix:MS
First Name:KEM
Middle Name:DENICE
Last Name:FRASIER
Suffix:
Gender:F
Credentials:LPC/I
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:133 PINE CREST VIEW DR
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29486-2486
Mailing Address - Country:US
Mailing Address - Phone:843-260-5361
Mailing Address - Fax:843-638-8884
Practice Address - Street 1:133 PINE CREST VIEW DR
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29486-2486
Practice Address - Country:US
Practice Address - Phone:843-260-5361
Practice Address - Fax:843-638-8884
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2024-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YP2500X, 101Y00000X, 101YM0800X
SCNONE171W00000X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No171W00000XOther Service ProvidersContractor
No111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11850682OtherCAQH PROVIDER ID
GA11850682OtherCAQH PROVIDER ID
NC0835902OtherLLC SEC STATE R.L.L. ID #
GA1962447102Medicaid
35-2528999OtherEIN