NPIMap

Individual provider Active NPI

Steve Cory Frazier, SAC-IT

  • Addiction (Substance Use Disorder) Counselor
  • Mequon, WI
National Provider Identifier
1588093231
Registry record updated Nov 4, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
15621-130 Issued in WI
Practice address
10532 N Port Washington Rd Ste 1B
Mequon, WI 53092-5563
Phone
(262) 242-3810
Fax
(262) 242-3816
NPI assigned
Nov 4, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 4, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 15621-130 WI Primary

Addresses

Primary practice location

10532 N Port Washington Rd Ste 1B
Mequon, WI 53092-5563

Mailing address

10532 N Port Washington Rd Ste 1B
Mequon, WI 53092-5563
Phone (262) 242-3810

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

State licenses

LicenseStateTypeSpecialty
15621-130WIMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383523200000",
    "number": "1588093231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10532 N PORT WASHINGTON RD STE 1B",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925563",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10532 N PORT WASHINGTON RD STE 1B",
            "city": "MEQUON",
            "state": "WI",
            "postal_code": "530925563",
            "telephone_number": "262-242-3810",
            "fax_number": "262-242-3816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAZIER",
        "first_name": "STEVE",
        "middle_name": "CORY",
        "name_prefix": "Mr.",
        "credential": "SAC-IT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-11-04",
        "last_updated": "2013-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "15621-130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mequon, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.