Provider Demographics
NPI:1194281485
Name:FRAZIER, GERIANNA KNEELAND (MS, NCC, LPC-MHSP)
Entity type:Individual
Prefix:
First Name:GERIANNA
Middle Name:KNEELAND
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MS, NCC, LPC-MHSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13522 N FIELDS LN
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRANCH
Mailing Address - State:MS
Mailing Address - Zip Code:38654-1079
Mailing Address - Country:US
Mailing Address - Phone:901-857-7599
Mailing Address - Fax:
Practice Address - Street 1:13522 N FIELDS LN
Practice Address - Street 2:
Practice Address - City:OLIVE BRANCH
Practice Address - State:MS
Practice Address - Zip Code:38654-1079
Practice Address - Country:US
Practice Address - Phone:901-857-7599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-12
Last Update Date:2023-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC010101101YM0800X
TNLPC5490101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health