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NPI Code Detail

MEDICARE: MRS. JOAN C. FRAIFELD MSSW, LCSW

MEDICARE: MRS. JOAN C. FRAIFELD MSSW, 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
11041C0700XClinical Social Worker0904003756VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306946298
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. JOAN C. FRAIFELD MSSW, LCSW
Provider Business Mailing Address
First Line : 3511 W. MARKET S., STE. 100
Second Line : TRIAD PSYCHIATRIC COUNSELING CENTER
City : GREENSBORO
State : NC
Zip : 27403-4444
Country : US
Telephone Number : 336-632-3505
Fax Number : 336-632-3503
Provider Business Practice Location Address
First Line : 3511 W. MARKET S., STE. 100
Second Line : TRIAD PSYCHIATRIC COUNSELING CENTER
City : GREENSBORO
State : NC
Zip : 27403-4444
Country : US
Telephone Number : 336-632-3505
Fax Number : 336-632-3503
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/22/2006
Last Update Date : 09/01/2011

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