Active NPI
Fred Emery Stickle, PH.D.
- Professional Counselor
- Bowling Green, KY
National Provider Identifier
1124245717
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0024
- Practice address
- 410 East 11TH
Bowling Green, KY 42101 - Phone
- (270) 842-2102
- Fax
- (270) 782-5312
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0024 | KY | Primary |
| Marriage & Family Therapist | 106H00000X | 0048 | KY |
Addresses
Primary practice location
410 East 11TH
Bowling Green, KY 42101
Mailing address
410 East 11TH
Bowling Green, KY 42101
Phone (270) 842-2102
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)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0048 | KY | MD | Psychologist |
| 0024 | KY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1757548800000",
"number": "1124245717",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "410 EAST 11TH",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "42101",
"telephone_number": "270-842-2102",
"fax_number": "270-782-5312"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 EAST 11TH",
"city": "BOWLING GREEN",
"state": "KY",
"postal_code": "42101",
"telephone_number": "270-842-2102",
"fax_number": "270-782-5312"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STICKLE",
"first_name": "FRED",
"middle_name": "EMERY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-18",
"last_updated": "2025-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "KY",
"license": "0024",
"primary": true
},
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "KY",
"license": "0048",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bowling Green, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.