| Patrice M Fraser, LCSW | |
|
320 S Locust St, Carlinville, IL 62626-1648 | |
| (217) 854-3166 | |
| (217) 854-3778 |
| Full Name | Patrice M Fraser |
|---|---|
| Gender | Female |
| Speciality | Social Worker - Clinical |
| Location | 320 S Locust St, Carlinville, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659966349 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 149.010195 (Illinois) | Primary |
| Entity Name | Locust Street Resource Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558456210 PECOS PAC ID: 6002846599 Enrollment ID: O20050815000615 |
| Mailing Address | Practice Location Address |
|---|---|
| Patrice M Fraser, LCSW 20596 Timbered Estates Ln, Carlinville, IL 62626-3947 Ph: () - | Patrice M Fraser, LCSW 320 S Locust St, Carlinville, IL 62626-1648 Ph: (217) 854-3166 |
Wayne Spicer Jr., LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 1030 W Main St, Carlinville, IL 62626 Phone: 217-930-2106 | |
Andrea L Spicer, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 1030 W Main St, Carlinville, IL 62626 Phone: 217-930-2106 | |
Brian Stoops, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 20613 N Broad St Ste B, Carlinville, IL 62626 Phone: 217-854-3881 | |
Mrs. Lisa Hauter, LCSW CSADF Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 320 South Locust Street, Carlinville, IL 62626 Phone: 217-854-3166 Fax: 217-854-9729 | |
Elizabeth Mcintosh, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 320 S Locust St, Carlinville, IL 62626 Phone: 217-854-3166 Fax: 217-854-3778 | |
Rachel Lauren Hibbard, LCSW Clinical Social Worker Medicare: Medicare Enrolled Practice Location: 320 S Locust St, Carlinville, IL 62626 Phone: 217-854-3166 Fax: 217-854-9729 |