Provider Demographics
NPI:1871722033
Name:FRAZER, VANESSA E (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:VANESSA
Middle Name:E
Last Name:FRAZER
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 GREEN AVE
Mailing Address - Street 2:APT 1
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071-1912
Mailing Address - Country:US
Mailing Address - Phone:201-403-3534
Mailing Address - Fax:
Practice Address - Street 1:601 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-3818
Practice Address - Country:US
Practice Address - Phone:201-339-9200
Practice Address - Fax:201-339-7842
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-09
Last Update Date:2019-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker