Carol Sullivan Fraiser, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

M9097 Issued in MS

Practice address

819 Central Ave
Bay St Louis, MS 39520-3913

Phone

(228) 467-1881

NPI assigned

Jul 12, 2018

Sex

Female

Sole proprietor

No

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.

• Gulf Coast Mental Health Center

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Gulfport, MS
  • NPI 1417934175
  NPD (past)

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

{
    "created_epoch": "1531353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531353600000",
    "number": "1922584028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 CARROLL AVE",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395203515",
            "telephone_number": "601-214-1308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "819 CENTRAL AVE",
            "city": "BAY ST LOUIS",
            "state": "MS",
            "postal_code": "395203913",
            "telephone_number": "228-467-1881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRAISER",
        "first_name": "CAROL",
        "middle_name": "SULLIVAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-12",
        "last_updated": "2018-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MS",
            "license": "M9097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Em Dimitri DO PMC
• Ethel W Hetrick PHD PLLC
• Keith M Everman, D.C.
• Meghan Flynt, LPC
• Maghan Foos, FNP-C
• James F. French, MD
• Kirsten Shelby Furr
• Laura Gamboa
• Donald Lynn Graves III, MS, ATC, LAT
• Guardian Senior Care, Inc.

• Social Worker in Bay St Louis, MS
• Providers in Bay St Louis, MS by specialty
• Social Worker in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2018; 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.