Provider Demographics
NPI:1669238259
Name:YANEY - FRAZIER, THOMAS EUGENE
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:EUGENE
Last Name:YANEY - FRAZIER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 W MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LIMA
Mailing Address - State:OH
Mailing Address - Zip Code:45801-4713
Mailing Address - Country:US
Mailing Address - Phone:740-901-3049
Mailing Address - Fax:740-901-3040
Practice Address - Street 1:319 W MARKET ST
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45801-4713
Practice Address - Country:US
Practice Address - Phone:740-901-3049
Practice Address - Fax:740-901-3040
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-22
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health