Christopher H. Fraczek, PSY.D.
Individual provider Active NPI Clinical Psychologist · Anchorage, AK
NPI 1497906986 · NPPES record last updated Mar 22, 2023
Key facts
- NPI
- 1497906986
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PY61018950 (WA)
- Practice address
- 4105 Tudor Centre Dr
100
Anchorage, AK 99508-5902 - Phone
- (907) 565-4000
- Fax
- (907) 565-4011
- NPI assigned
- Oct 2, 2008
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Western Psychological and Counseling Services LLC
Practice addresses (Care Compare)
12636 SE Stark St Plaza 125 BLDG J
Portland, OR 97233-1058
Phone (503) 253-4600
7507 NE 51St St
Vancouver, WA 98662-6007
Phone (360) 906-1190
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in WA, OR
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20200407002169 | WA | Practitioner - Clinical Psychologist | 1951730282 | Reassigns benefits to 1 organization |
| I20201130002302 | OR | Practitioner - Clinical Psychologist | 1951730282 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3272 | OR | MD | Clinical Psychologist |
| PY61018950 | WA | MD | Clinical Psychologist |
| 576 | AK | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Western Psychological and Counseling Services LLC | Clinical | Current |
Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
880 82nd Dr
Gladstone, OR 97027
Phone (503) 626-9494
12636 SE Stark St
Bldg J
Portland, OR 97233
Phone (503) 253-4600
19120 SE 34th St
Ste 201
Vancouver, WA 98683
Phone (360) 906-1190
7507 NE 51st St
Vancouver, WA 98662
Phone (360) 906-1190
Interoperability endpoints
- chrisf@monarch-psychiatry.direct.kno2fy.com
- lifestancehealth.christopherfraczek@148835.advancedmd-direct.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 3272 | OR | |
| Clinical Psychologist | 103TC0700X | 576 | AK | |
| Clinical Psychologist | 103TC0700X | PY61018950 | WA | Yes |
Addresses
Primary practice location
4105 Tudor Centre Dr
100
Anchorage, AK 99508-5902
Mailing address
19120 SE 34TH St Ste 201
Vancouver, WA 98683-1430
Phone (253) 352-2480
Other providers in Anchorage, AK
- Stephanie M Fox
- Tammy Fox
- Foxglove Care Coordination LLC
- Steven Quan Foy
- Stephanie Rose Frackman
- Jennifer Diane Fraiser
- Rheanna Frampton
- Jay Dean Francis
- Jimmie Lynne Francis
- Agnes Francisco
All providers in Anchorage, AK · Clinical Psychologist in Alaska
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.