Pascal Davis Fraisse, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L9163 Issued in MS

Practice address

2620 Executive PL
Biloxi, MS 39531-3717

Phone

(228) 385-7744

NPI assigned

Sep 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Psycamore, LLC

  • Adult Mental Health Clinic/Center
  • Biloxi, MS
  • NPI 1003195967
  NPD (past)

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

{
    "created_epoch": "1663545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1750004495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2620 EXECUTIVE PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313717",
            "telephone_number": "228-385-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2620 EXECUTIVE PL",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395313717",
            "telephone_number": "228-385-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAISSE",
        "first_name": "PASCAL",
        "middle_name": "DAVIS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-19",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MS",
            "license": "L9163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Theresa Flanagan Fordham, LPC LSW
• Fortress Clinical Research Inc
• Michael L. Foss, M.D.
• Jason Harding Foster, D.O.
• Tonya Katina Fountain-Adams, NURSE PRACTITIONER
• Joshua Francis, PHARMD
• Mark Lee Francis, CRNA
• Sara J Franklin, AU.D.
• David Alan Franks, PSYD
• McKenzie Frederick

• All providers in Biloxi, MS
• Clinical Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2022; 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.