MEDICARE: CARLY FRASCINO LCSW

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	1041C0700X	Clinical Social Worker	44SC06487600	NJ

General Provider Information

NPI Number	:	1154113165
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLY FRASCINO LCSW

Provider Business Mailing Address
First Line	:	18 ROBERT TER
Second Line	:
City	:	JACKSON
State	:	NJ
Zip	:	08527-1117
Country	:	US
Telephone Number	:	732-713-6279
Fax Number	:

Provider Business Practice Location Address
First Line	:	55 N GILBERT ST STE 3202
Second Line	:
City	:	TINTON FALLS
State	:	NJ
Zip	:	07701-4962
Country	:	US
Telephone Number	:	732-440-8934
Fax Number	:

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

Provider Enumeration Date	:	05/19/2025
Last Update Date	:	05/19/2025

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Directions to “ CARLY FRASCINO LCSW” Practice Location

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