MEDICARE: LESLEY FRAZIER

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
1	171M00000X	Case Manager/Care Coordinator
2	101YA0400X	Addiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number	:	1124519947
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LESLEY FRAZIER

Provider Business Mailing Address
First Line	:	1648 ELMWOOD DR
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004-9037
Country	:	US
Telephone Number	:	440-855-3853
Fax Number	:

Provider Business Practice Location Address
First Line	:	1648 ELMWOOD DR
Second Line	:
City	:	ASHTABULA
State	:	OH
Zip	:	44004-9037
Country	:	US
Telephone Number	:	440-855-3853
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/29/2018
Last Update Date	:	03/12/2026

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Directions to “ LESLEY FRAZIER ” Practice Location

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