Active NPI
Traci Fraley, PH.D.
- Psychologist
- Summerville, SC
National Provider Identifier
1699876383
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 957
- Practice address
- 225 Midland Pkwy
Summerville, SC 29485-8104 - Phone
- (843) 851-5015
- Fax
- (843) 851-5029
- NPI assigned
- Sep 26, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychologist | 103T00000X | 957 | SC | Primary |
Addresses
Primary practice location
225 Midland Pkwy
Summerville, SC 29485-8104
Mailing address
2508 Melville Rd
N Charleston, SC 29406-9798
Phone (843) 860-5955
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7369 | OH | MD | Physical Therapist |
| 957 | SC | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1699876383",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2508 MELVILLE RD",
"city": "N CHARLESTON",
"state": "SC",
"postal_code": "294069798",
"telephone_number": "843-860-5955"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "225 MIDLAND PKWY",
"city": "SUMMERVILLE",
"state": "SC",
"postal_code": "294858104",
"telephone_number": "843-851-5015",
"fax_number": "843-851-5029"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRALEY",
"first_name": "TRACI",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-26",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "SC",
"license": "957",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Summerville, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.