Provider Demographics
NPI:1548638042
Name:FRAZEE, KATHERINE EILEEN (LCPC)
Entity type:Individual
Prefix:MRS
First Name:KATHERINE
Middle Name:EILEEN
Last Name:FRAZEE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11411 BAKER RD
Mailing Address - Street 2:
Mailing Address - City:KEYMAR
Mailing Address - State:MD
Mailing Address - Zip Code:21757-8119
Mailing Address - Country:US
Mailing Address - Phone:240-446-9015
Mailing Address - Fax:
Practice Address - Street 1:1311 ORCHARD WAY
Practice Address - Street 2:
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21703-6090
Practice Address - Country:US
Practice Address - Phone:240-446-9015
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-14
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6481101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional