Provider Demographics
NPI:1447267828
Name:FRAZIER, LORI ANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:ANN
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:ANN
Other - Last Name:WHEELHOUSE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:413 NE 114TH STREET
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64155-1736
Mailing Address - Country:US
Mailing Address - Phone:816-536-1074
Mailing Address - Fax:816-479-2903
Practice Address - Street 1:1812 MIDDLEMARCH TER
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-2961
Practice Address - Country:US
Practice Address - Phone:816-536-1074
Practice Address - Fax:816-479-2903
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO499269009Medicaid