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NPI Code Detail

MEDICARE: ROSEMARY FRAZEL L.I.C.S.W.

MEDICARE: ROSEMARY FRAZEL L.I.C.S.W.
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 Worker22887MN

General Provider Information

NPI Number : 1659817237
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSEMARY FRAZEL L.I.C.S.W.
Provider Business Mailing Address
First Line : 4123 E LAKE ST
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55406-2255
Country : US
Telephone Number : 612-728-2061
Fax Number : 612-728-2095
Provider Business Practice Location Address
First Line : 1100 GLENWOOD AVE
Second Line :
City : MINNEAPOLIS
State : MN
Zip : 55405-1430
Country : US
Telephone Number : 612-871-1454
Fax Number : 612-871-1505
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2017
Last Update Date : 05/12/2026

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