MEDICARE: ELYSE HELEN FROSCH M.ED/ED.S, LPC

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	101Y00000X	Counselor

General Provider Information

NPI Number	:	1912226028
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELYSE HELEN FROSCH M.ED/ED.S, LPC

Provider Business Mailing Address
First Line	:	911 CAROLINA AVE APT A
Second Line	:
City	:	DURHAM
State	:	NC
Zip	:	27705-4003
Country	:	US
Telephone Number	:	954-290-7287
Fax Number	:

Provider Business Practice Location Address
First Line	:	3801 LAKE BOONE TRL STE 100
Second Line	:
City	:	RALEIGH
State	:	NC
Zip	:	27607-2994
Country	:	US
Telephone Number	:	919-368-6373
Fax Number	:

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

Provider Enumeration Date	:	05/28/2010
Last Update Date	:	07/24/2013

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