Healthcare Provider Details

I. General information

NPI: 1285611145
Provider Name (Legal Business Name): CHRISTOPHER A FRAZER PSY.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/30/2005
Last Update Date: 10/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 OLD WESTPORT RD UMASS DARTMOUTH COUNSELING CENTER
DARTMOUTH MA
02747-2356
US

IV. Provider business mailing address

285 OLD WESTPORT RD. UMASS DARTMOUTH COUNSELING CENTER
DARTMOUTH MA
02747-2356
US

V. Phone/Fax

Practice location:
  • Phone: 508-999-8650
  • Fax: 508-999-9192
Mailing address:
  • Phone: 508-999-8650
  • Fax: 508-999-9192

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5820
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number10218
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: