Provider Demographics
NPI:1609681055
Name:DEVIN FRAZIER PSYCHOLOGICAL SERVICES, INC
Entity type:Organization
Organization Name:DEVIN FRAZIER PSYCHOLOGICAL SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, LICENSED PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:DEVIN
Authorized Official - Middle Name:
Authorized Official - Last Name:FRAZIER
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LP
Authorized Official - Phone:614-578-6317
Mailing Address - Street 1:31103 ORANGELAWN ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-2926
Mailing Address - Country:US
Mailing Address - Phone:614-578-6317
Mailing Address - Fax:
Practice Address - Street 1:5340 PLYMOUTH RD STE AOFFICE1
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-9341
Practice Address - Country:US
Practice Address - Phone:614-578-6317
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1134601628Medicaid