Wallace J Fraser Jr, LCPC | |
27 Wilbur Dr, Hampden, ME 04444-1420 | |
(207) 735-7136 | |
(207) 433-1462 |
Full Name | Wallace J Fraser Jr |
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Gender | Male |
Speciality | Counselor - Mental Health |
Location | 27 Wilbur Dr, Hampden, Maine |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1578790499 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YM0800X | Counselor - Mental Health | CC3848 (Maine) | Primary |
Entity Name | Fraser Clinical Consultation Services |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1629530530 PECOS PAC ID: 5496199879 Enrollment ID: O20240214001796 |
Mailing Address | Practice Location Address |
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Wallace J Fraser Jr, LCPC 27 Wilbur Dr, Hampden, ME 04444-1420 Ph: (207) 735-7136 | Wallace J Fraser Jr, LCPC 27 Wilbur Dr, Hampden, ME 04444-1420 Ph: (207) 735-7136 |
Louise Adelstone, Counselor Medicare: Not Enrolled in Medicare Practice Location: 60 Town Farm Rd, Hampden, ME 04444 Phone: 505-417-1195 | |
Mrs. Megan Elizabeth Smith, LCPC-C Counselor Medicare: Not Enrolled in Medicare Practice Location: 56 Hughes Blvd, Hampden, ME 04444 Phone: 207-299-7729 | |
Mr. Keith Gordon Tibbetts, LCPC Counselor Medicare: Not Enrolled in Medicare Practice Location: 50 Emerald Drive, Hampden, ME 04444 Phone: 207-307-4505 Fax: 207-941-2955 | |
Mrs. Lauren Viles O'reilly, Counselor Medicare: Not Enrolled in Medicare Practice Location: 101 Sidney Blvd, Hampden, ME 04444 Phone: 207-314-4336 | |
Mrs. Kristyn Harriman Smith, LCPC-C Counselor Medicare: Not Enrolled in Medicare Practice Location: 25 Mayo Road, Hampden, ME 04444 Phone: 207-862-2384 | |
Kelly Redmond, LCPC, LADC, CCS Counselor Medicare: Not Enrolled in Medicare Practice Location: 293 Coldbrook Rd, Hampden, ME 04444 Phone: 207-424-1704 |