Healthcare Provider Details

I. General information

NPI: 1376892885
Provider Name (Legal Business Name): CEVONNA FRAZIER FINE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CEVONNA MARIE FRAZIER MSW

II. Dates (important events)

Enumeration Date: 08/30/2012
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

977 ENOTA AVE NE
GAINESVILLE GA
30501-1700
US

IV. Provider business mailing address

2800 SCENIC DR STE 4
BLUE RIDGE GA
30513-1414
US

V. Phone/Fax

Practice location:
  • Phone: 470-290-8363
  • Fax:
Mailing address:
  • Phone: 762-210-8069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW005731
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: