Provider Demographics
NPI:1386375004
Name:FRAILEY, MORIAH IRENE (LCSW)
Entity type:Individual
Prefix:
First Name:MORIAH
Middle Name:IRENE
Last Name:FRAILEY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MORIAH
Other - Middle Name:IRENE
Other - Last Name:HARMS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:26 S BROAD ST APT S4
Mailing Address - Street 2:
Mailing Address - City:NAZARETH
Mailing Address - State:PA
Mailing Address - Zip Code:18064-2117
Mailing Address - Country:US
Mailing Address - Phone:484-788-3236
Mailing Address - Fax:
Practice Address - Street 1:85 CRESCENT AVE
Practice Address - Street 2:
Practice Address - City:PASSAIC
Practice Address - State:NJ
Practice Address - Zip Code:07055-2437
Practice Address - Country:US
Practice Address - Phone:973-264-0023
Practice Address - Fax:973-264-0022
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0221331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical