Fraser Clinical Consultation Services

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

FRASER CLINICAL CONSULTATION SERVICES

Practice address

27 Wilbur Dr
Hampden, ME 04444-1420

Phone

(207) 735-7136

NPI assigned

Apr 1, 2019

Last updated

Jan 11, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Wallace J Fraser Jr., LCPCNPI 1578790499

Title

Counselor

Phone

(207) 735-7136

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ME

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Wallace J Fraser Jr., LCPC

  • Mental Health Counselor
  • Hampden, ME
  • NPI 1578790499
  Medicare reassignment NPD Authorized official
• Hayle Grover

  • Clinical Social Worker
  • Yarmouth, ME
  • NPI 1881574234
  NPD
• Hannah S. Longley, LCSW

  • Clinical Social Worker
  • Augusta, ME
  • NPI 1104006774
  NPD

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704931200000",
    "number": "1629530530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 WILBUR DR",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441420",
            "telephone_number": "207-735-7136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 WILBUR DR",
            "city": "HAMPDEN",
            "state": "ME",
            "postal_code": "044441420",
            "telephone_number": "207-735-7136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRASER CLINICAL CONSULTATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-01-11",
        "certification_date": "2024-01-11",
        "status": "A",
        "authorized_official_last_name": "FRASER",
        "authorized_official_first_name": "WALLACE",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "COUNSELOR",
        "authorized_official_telephone_number": "207-735-7136",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lynn Ferguson, PMHNP
• Scott Flagg, OTR/L
• Jennifer Lynn Fleming, DPT
• Leigh J Forbush, DO
• Charity-Leigh Fournier
• Wallace J Fraser Jr., LCPC
• Fundamental Foot Care, PLLC
• Ashley Gagnon, PT, DPT
• Emily Grace Gazitua, D.M.D.
• Gentiva Health Services

• Community/Behavioral Health Agency in Hampden, ME
• Providers in Hampden, ME by specialty
• Community/Behavioral Health Agency in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.