Provider Demographics
NPI:1831705821
Name:FRASERS COMPLETE THERAPEUTIC SERVICES
Entity type:Organization
Organization Name:FRASERS COMPLETE THERAPEUTIC SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARYL
Authorized Official - Middle Name:VOLNEY
Authorized Official - Last Name:FRASER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:804-363-6693
Mailing Address - Street 1:306 TURNER RD STE L
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23225-6432
Mailing Address - Country:US
Mailing Address - Phone:804-363-6693
Mailing Address - Fax:
Practice Address - Street 1:306 TURNER RD STE L
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23225-6432
Practice Address - Country:US
Practice Address - Phone:804-363-6693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-09-16
Last Update Date:2021-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty