Provider Demographics
NPI:1750804142
Name:FRINK, LASHONEY JERMELL
Entity type:Individual
Prefix:
First Name:LASHONEY
Middle Name:JERMELL
Last Name:FRINK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 DESSIE RD
Mailing Address - Street 2:
Mailing Address - City:CHADBOURN
Mailing Address - State:NC
Mailing Address - Zip Code:28431-2532
Mailing Address - Country:US
Mailing Address - Phone:910-654-6060
Mailing Address - Fax:
Practice Address - Street 1:44 DREAM AVE
Practice Address - Street 2:
Practice Address - City:DELCO
Practice Address - State:NC
Practice Address - Zip Code:28436-8700
Practice Address - Country:US
Practice Address - Phone:910-655-0698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-18
Last Update Date:2017-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP011645101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional