1376892885 NPI number — MS. CEVONNA FRAZIER FINE LCSWA

Table of content: MS. CEVONNA FRAZIER FINE LCSWA (NPI 1376892885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376892885 NPI number — MS. CEVONNA FRAZIER FINE LCSWA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FINE
Provider First Name:
CEVONNA
Provider Middle Name:
FRAZIER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LCSWA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRAZIER
Provider Other First Name:
CEVONNA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1376892885
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/06/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 444
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MURPHY
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28906-0444
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
828-837-0071
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
750 US HIGHWAY 64 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MURPHY
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28906
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
828-837-0071
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2012

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: 1041C0700X , with the licence number:  P007568 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com