Alicia Jane Fry, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

079788-1 Issued in NY

Practice address

8802 Rockaway Beach Blvd
Rockaway Beach, NY 11693-1609

Phone

(718) 634-3461

Fax

(718) 851-3470

NPI assigned

May 11, 2019

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ms. Alicia Jane Wiltsey Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1557532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560211200000",
    "number": "1255997623",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18419 50TH AVE APT 1",
            "city": "FRESH MEADOWS",
            "state": "NY",
            "postal_code": "113651601",
            "telephone_number": "718-357-0459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8802 ROCKAWAY BEACH BLVD",
            "city": "ROCKAWAY BEACH",
            "state": "NY",
            "postal_code": "116931609",
            "telephone_number": "718-634-3461",
            "fax_number": "718-851-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "ALICIA",
        "middle_name": "JANE",
        "name_prefix": "Ms.",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-11",
        "last_updated": "2019-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "079788-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEW YORK STATE DEPARTMENT OF EDUCATION-LICENSED MASTER SOCIAL WORKER",
            "identifier": "079788-1",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALICIA",
            "last_name": "WILTSEY",
            "middle_name": "JANE",
            "prefix": "MS.",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Laurie Esposito, DDS
• Jonathan Richard Estrella
• Joshua David Farkas, LMSW
• Olena Fayerman
• Elizabeth Felix, LMSW
• Elizabeth Fuentes
• Sunila Y Gadgil, M.D.
• Marcos Garcia
• Geraldine Vicki Goldman, CRC
• Ida Blan Goodwine, LMSW

• Social Worker in Rockaway Beach, NY
• Providers in Rockaway Beach, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.