Provider Demographics
NPI:1972916187
Name:FRAZIER, AMANDA LEA (MS, LPC, NCC, PMH-C)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LEA
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:MS, LPC, NCC, PMH-C
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:LEA
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1307 S MAIN ST STE B
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MI
Mailing Address - Zip Code:48118-1479
Mailing Address - Country:US
Mailing Address - Phone:517-201-0346
Mailing Address - Fax:
Practice Address - Street 1:1307 S MAIN ST STE B
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MI
Practice Address - Zip Code:48118-1479
Practice Address - Country:US
Practice Address - Phone:517-201-0346
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014376101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health