Provider Demographics
NPI:1194092593
Name:FRAZIER, TERRELL REGINALDO (LCSW, MAC, CADC)
Entity type:Individual
Prefix:MR
First Name:TERRELL
Middle Name:REGINALDO
Last Name:FRAZIER
Suffix:
Gender:M
Credentials:LCSW, MAC, CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1213 JERNIGAN CT
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-2489
Mailing Address - Country:US
Mailing Address - Phone:404-964-6792
Mailing Address - Fax:
Practice Address - Street 1:1213 JERNIGAN CT
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-2489
Practice Address - Country:US
Practice Address - Phone:404-964-6792
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical