Healthcare Provider Details

I. General information

NPI: 1669015335
Provider Name (Legal Business Name): FRAZIER BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2019
Last Update Date: 12/09/2022
Certification Date: 12/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5885 LANDERBROOK DR STE 310
MAYFIELD HEIGHTS OH
44124-4031
US

IV. Provider business mailing address

841 E FAYETTE ST
SYRACUSE NY
13210-1521
US

V. Phone/Fax

Practice location:
  • Phone: 216-446-2944
  • Fax:
Mailing address:
  • Phone: 216-446-2944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: ALLISON WRIGHT-FRAZIER
Title or Position: CEO
Credential: BCBA
Phone: 216-446-2944