Brenda Joy Fricke, MA, LPC
Individual provider Active NPI Professional Counselor · Dixon, MO
NPI 1114077864 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1114077864
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Professional Counselor 101YP2500X
- License
- 2003002001 (MO)
- Practice address
- 402 S Elm
Box 798
Dixon, MO 65459 - Phone
- (573) 528-3558
- Fax
- (573) 774-6992
- NPI assigned
- Jan 12, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2003002001 | MO | MD | Professional Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 2003002001 | MO | Yes |
Addresses
Primary practice location
402 S Elm
Box 798
Dixon, MO 65459
Mailing address
25945 Sandlewood LN
PO Box 175
Laquey, MO 65534-7615
Phone (573) 528-3558
Other providers in Dixon, MO
- Dixon Family Practice and Internal Medicine, LLC
- Dixon Reorganized Dist R1
- Daniel Draper
- Heidi Lynn Ellwood
- Jessica Janet Forlani
- Whitney George
- Yvette Labajo Golicki
- Mary Kaye Hall
- Hometown Pharmacy
- Emily Kluck
All providers in Dixon, MO · Professional Counselor in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.