Active NPI
Jennifer Fries, LCSW
- Psychiatry Physician
- Dallas, TX
National Provider Identifier
1073574158
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 36632
- Practice address
- 8210 Walnut Hill LN
Dallas, TX 75231-4405 - Phone
- (214) 345-7355
- NPI assigned
- Mar 29, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 36632 | TX | Primary |
Addresses
Primary practice location
8210 Walnut Hill LN
Dallas, TX 75231-4405
Mailing address
PO Box 910042
Dallas, TX 75391-0042
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 86526Q | Other | TX | BCBS |
Other names 1
- Jennifer Malone
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36632 | TX | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1143590400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1207180800000",
"number": "1073574158",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 910042",
"city": "DALLAS",
"state": "TX",
"postal_code": "753910042"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8210 WALNUT HILL LN",
"city": "DALLAS",
"state": "TX",
"postal_code": "752314405",
"telephone_number": "214-345-7355"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIES",
"first_name": "JENNIFER",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-03-29",
"last_updated": "2008-04-03",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "TX",
"license": "36632",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "86526Q",
"state": "TX"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "JENNIFER",
"last_name": "MALONE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.