Individual provider Active NPI

Charlene Marie Fries, M.S.,ED.S, BCBA

  • Behavior Analyst
  • Hallandale Beach, FL
National Provider Identifier
1265009278
Registry record updated Oct 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
403 NE 2ND Ave
Hallandale Beach, FL 33009-4215
Phone
(954) 256-0357
NPI assigned
Jun 8, 2021
Last updated
Oct 13, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 13, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X NU Primary

Addresses

Primary practice location

403 NE 2ND Ave
Hallandale Beach, FL 33009-4215

Mailing address

403 NE 2ND Ave
Hallandale Beach, FL 33009-4215
Phone (954) 256-0357

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
Master of Science

Practice roles

OrganizationSpecialtyStatusNew patients
Kiwi Behavioral Therapy, LLC Behavior Analyst CurrentSince Oct 21, 2025 Accepting new patients

Locations

107 NE 3rd St
Ste 1
Hallandale Beach, FL 33009

403 NE 2nd Ave
Hallandale Beach, FL 33009
Phone (786) 547-3522

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1623110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760313600000",
    "number": "1265009278",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "403 NE 2ND AVE",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094215",
            "telephone_number": "954-256-0357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "403 NE 2ND AVE",
            "city": "HALLANDALE BEACH",
            "state": "FL",
            "postal_code": "330094215",
            "telephone_number": "954-256-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "CHARLENE",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "M.S.,ED.S, BCBA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-08",
        "last_updated": "2025-10-13",
        "certification_date": "2025-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hallandale Beach, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 13, 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.

Verify at the official NPI Registry.