Active NPI
Marie Fraser
- Professional Counselor
- Rome, GA
National Provider Identifier
1063956472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC007986
- Practice address
- 14 Wagnon CT SE
Rome, GA 30161-2199 - Phone
- (770) 853-3627
- NPI assigned
- Dec 5, 2016
- Last updated
- Dec 5, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC007986 | GA | Primary |
Addresses
Primary practice location
14 Wagnon CT SE
Rome, GA 30161-2199
Mailing address
14 Wagnon CT SE
Rome, GA 30161-2199
Phone (770) 853-3627
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1480896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480896000000",
"number": "1063956472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WAGNON CT SE",
"city": "ROME",
"state": "GA",
"postal_code": "301612199",
"telephone_number": "770-853-3627"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 WAGNON CT SE",
"city": "ROME",
"state": "GA",
"postal_code": "301612199",
"telephone_number": "770-853-3627"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER",
"first_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-12-05",
"last_updated": "2016-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC007986",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.