1174646475 NPI number — ANNE MAGILL FRAUENS LCSW

Table of content: ANNE MAGILL FRAUENS LCSW (NPI 1174646475)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174646475 NPI number — ANNE MAGILL FRAUENS LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRAUENS
Provider First Name:
ANNE
Provider Middle Name:
MAGILL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRAUENS
Provider Other First Name:
ANNE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1174646475
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
423 DEER TRAIL HL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE BARRINGTON
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60010-1703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-540-4199
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
423 DEER TRAIL HL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAKE BARRINGTON
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60010-1703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-540-4199
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  LCSW-3018 , registered in the state of HI ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: C009200 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X , with the licence number: 12309 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00B0221057 . This is a "HMSA 65C PLUS" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00221057 . This is a "HMSA" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00B0221057 . This is a "TRICARE PROVIDER NUMBER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00B0221057 . This is a "QUEST PROVIDER NUMBER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00B0221057 . This is a "HMSA PROVIDER NUMBER" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 00B0221057 . This is a "HMSA PPO" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 499328 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".




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