Provider Demographics
NPI:1831616572
Name:FRASER, KATE ANN (LMSW)
Entity type:Individual
Prefix:MS
First Name:KATE
Middle Name:ANN
Last Name:FRASER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4241
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29608-4241
Mailing Address - Country:US
Mailing Address - Phone:864-242-9193
Mailing Address - Fax:
Practice Address - Street 1:415 RUTHERFORD ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29609-5311
Practice Address - Country:US
Practice Address - Phone:864-242-9193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-24
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12207101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health