Provider Demographics
NPI:1700324670
Name:FRAZEE, ANGELA (LCPC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:
Last Name:FRAZEE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 SAINT JOHNS LN STE 207
Mailing Address - Street 2:
Mailing Address - City:ELLICOTT CITY
Mailing Address - State:MD
Mailing Address - Zip Code:21042-4046
Mailing Address - Country:US
Mailing Address - Phone:410-719-0086
Mailing Address - Fax:
Practice Address - Street 1:3570 SAINT JOHNS LN STE 207
Practice Address - Street 2:
Practice Address - City:ELLICOTT CITY
Practice Address - State:MD
Practice Address - Zip Code:21042-4046
Practice Address - Country:US
Practice Address - Phone:410-719-0086
Practice Address - Fax:443-251-2664
Is Sole Proprietor?:No
Enumeration Date:2017-02-10
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC7669101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional