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NPI Code Detail

MEDICARE: MS. SHANIECE SALLIE FRASER LMSW

MEDICARE: MS. SHANIECE SALLIE FRASER LMSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor108946-01NY

General Provider Information

NPI Number : 1437765245
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHANIECE SALLIE FRASER LMSW
Provider Business Mailing Address
First Line : 262 E. 55TH ST
Second Line : 1B
City : BROOKLYN
State : NY
Zip : 11203
Country : US
Telephone Number : 347-615-3212
Fax Number :
Provider Business Practice Location Address
First Line : 921 E NEW YORK AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11203-1393
Country : US
Telephone Number : 718-778-0485
Fax Number : 718-778-1375
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2020
Last Update Date : 03/25/2025

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