Provider Demographics
NPI:1952694812
Name:FRAZIER, JASON JEROME (MS, MFT)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:JEROME
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:MS, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 MARKET PLACE DR
Mailing Address - Street 2:201 C
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-1698
Mailing Address - Country:US
Mailing Address - Phone:603-724-1491
Mailing Address - Fax:
Practice Address - Street 1:4 MARKET PLACE DR
Practice Address - Street 2:201 C
Practice Address - City:YORK
Practice Address - State:ME
Practice Address - Zip Code:03909-1698
Practice Address - Country:US
Practice Address - Phone:603-724-1491
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health