Provider Demographics
NPI:1215112297
Name:FRAGER ASSOCIATES
Entity type:Organization
Organization Name:FRAGER ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:RAY
Authorized Official - Last Name:FRAGER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:502-426-4716
Mailing Address - Street 1:7400 NEW LAGRANGE RD
Mailing Address - Street 2:SUITE 404
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-4870
Mailing Address - Country:US
Mailing Address - Phone:502-426-4716
Mailing Address - Fax:502-426-4717
Practice Address - Street 1:7400 NEW LAGRANGE RD
Practice Address - Street 2:SUITE 404
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-4870
Practice Address - Country:US
Practice Address - Phone:502-426-4716
Practice Address - Fax:502-426-4717
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-08
Last Update Date:2013-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1356103G00000X
KY0713103T00000X
KY1166103T00000X
KY18801041C0700X
KY19541041C0700X
KY0516103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Multi-Specialty
No103G00000XBehavioral Health & Social Service ProvidersClinical NeuropsychologistGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYCP00105Medicare PIN
R39990Medicare UPIN