Provider Demographics
NPI:1912226028
Name:FROSCH, ELYSE HELEN (MED/EDS, LPC)
Entity Type:Individual
Prefix:
First Name:ELYSE
Middle Name:HELEN
Last Name:FROSCH
Suffix:
Gender:F
Credentials:MED/EDS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 CAROLINA AVE APT A
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-4003
Mailing Address - Country:US
Mailing Address - Phone:954-290-7287
Mailing Address - Fax:
Practice Address - Street 1:3801 LAKE BOONE TRL STE 100
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-2994
Practice Address - Country:US
Practice Address - Phone:919-368-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor