Provider Demographics
NPI:1275415655
Name:FRAGINALS, ELYSA MICHELLE (PSYD)
Entity type:Individual
Prefix:DR
First Name:ELYSA
Middle Name:MICHELLE
Last Name:FRAGINALS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3402 BIXLER DR APT 2007
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-5114
Mailing Address - Country:US
Mailing Address - Phone:305-989-3333
Mailing Address - Fax:
Practice Address - Street 1:2540 EL PASEO RD STE B
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001-6019
Practice Address - Country:US
Practice Address - Phone:575-243-5846
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-24
Last Update Date:2025-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM2025103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical