Provider Demographics
NPI:1891672838
Name:FRAZIER, BRANDI LASHAY (PSS, SAS)
Entity type:Individual
Prefix:MS
First Name:BRANDI
Middle Name:LASHAY
Last Name:FRAZIER
Suffix:
Gender:F
Credentials:PSS, SAS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:911 S EDISTO DR
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-5631
Mailing Address - Country:US
Mailing Address - Phone:843-222-0171
Mailing Address - Fax:
Practice Address - Street 1:510 E CAROLINA AVE
Practice Address - Street 2:
Practice Address - City:HARTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29550-4396
Practice Address - Country:US
Practice Address - Phone:843-332-4156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-20
Last Update Date:2025-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCCPSS-2469261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder