Active NPI
Larry Frazier Jr.
- Pastoral Counselor
- Clinton, MD
National Provider Identifier
1346866522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- Practice address
- 4615 Mary Beth Blvd
Clinton, MD 20735-9625 - Phone
- (202) 246-1310
- NPI assigned
- Jun 23, 2020
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | MD | Primary | |
| Mental Health Counselor | 101YM0800X | MD |
Addresses
Primary practice location
4615 Mary Beth Blvd
Clinton, MD 20735-9625
Mailing address
4615 Mary Beth Blvd
Clinton, MD 20735-9625
Phone (202) 246-1310
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | Clinton | Health Information Exchange (HIE) | |
| Direct Messaging Address | larry.frazier1@waldenu.edu | Direct |
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)
- Not enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592870400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1592870400000",
"number": "1346866522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4615 MARY BETH BLVD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207359625",
"telephone_number": "202-246-1310"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4615 MARY BETH BLVD",
"city": "CLINTON",
"state": "MD",
"postal_code": "207359625",
"telephone_number": "202-246-1310"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRAZIER",
"first_name": "LARRY",
"name_prefix": "Mr.",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-06-23",
"last_updated": "2020-06-23",
"certification_date": "2020-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor, Pastoral",
"state": "MD",
"license": null,
"primary": true
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "Clinton",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4615 Mary Beth Blvd",
"city": "Clinton",
"state": "MD",
"country_code": "US",
"postal_code": "207359625",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "larry.frazier1@waldenu.edu",
"affiliation": "N",
"endpointDescription": "Direct Messaging",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "4615 Mary Beth Blvd",
"city": "Clinton",
"state": "MD",
"country_code": "US",
"postal_code": "207359625",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Clinton, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.