Provider Demographics
NPI:1366175598
Name:FRAZIER, VICTORIA (LPC)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 COLUMBIA RD STE 8
Mailing Address - Street 2:
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1477
Mailing Address - Country:US
Mailing Address - Phone:888-431-0889
Mailing Address - Fax:
Practice Address - Street 1:671 COLUMBIA RD STE 8
Practice Address - Street 2:
Practice Address - City:WESTLAKE
Practice Address - State:OH
Practice Address - Zip Code:44145-1477
Practice Address - Country:US
Practice Address - Phone:888-431-0889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-06
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC2204212101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHC2204212OtherLPC