Provider Demographics
NPI:1548301583
Name:NISELY FRAZIER, SHERI A (MSW LCSW ACSW)
Entity type:Individual
Prefix:MS
First Name:SHERI
Middle Name:A
Last Name:NISELY FRAZIER
Suffix:
Gender:F
Credentials:MSW LCSW ACSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2726 HORTON CT
Mailing Address - Street 2:
Mailing Address - City:NILES
Mailing Address - State:MI
Mailing Address - Zip Code:49120-9350
Mailing Address - Country:US
Mailing Address - Phone:269-687-1731
Mailing Address - Fax:
Practice Address - Street 1:300 N MICHIGAN ST STE 320
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46601-1295
Practice Address - Country:US
Practice Address - Phone:574-287-3223
Practice Address - Fax:574-287-1667
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34003880A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical