Active NPI
Carl Lawrence Fraser, LMSW
- Clinical Social Worker
- Holland, MI
National Provider Identifier
1124376751
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 6801094552
- Practice address
- 12265 James St
Holland, MI 49424-8613 - Phone
- (616) 494-5447
- NPI assigned
- Aug 29, 2012
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 6801094552 | MI | Primary |
Addresses
Primary practice location
12265 James St
Holland, MI 49424-8613
Mailing address
12265 James St
Holland, MI 49424-8613
Phone (616) 494-5447
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6801094552 | MI | MD | Clinical Social Worker |
Interoperability endpoints
- cfraser415248@direct.hfhs.org
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1346198400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1444003200000",
"number": "1124376751",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12265 JAMES ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494248613",
"telephone_number": "616-494-5447"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12265 JAMES ST",
"city": "HOLLAND",
"state": "MI",
"postal_code": "494248613",
"telephone_number": "616-494-5447"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRASER",
"first_name": "CARL",
"middle_name": "LAWRENCE",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-29",
"last_updated": "2015-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MI",
"license": "6801094552",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Holland, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.