Provider Demographics
NPI:1255892121
Name:FRASTER, BETH SUSAN (MSW)
Entity type:Individual
Prefix:MS
First Name:BETH
Middle Name:SUSAN
Last Name:FRASTER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 BEACON ST
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-3304
Mailing Address - Country:US
Mailing Address - Phone:617-455-5819
Mailing Address - Fax:
Practice Address - Street 1:63 BEACON ST
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-3304
Practice Address - Country:US
Practice Address - Phone:617-455-5819
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-25
Last Update Date:2019-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1021397OtherMA SOCIAL WORK LICENSE