Active NPI
Mikaela Teel Fry
- Counselor
- Moorestown, NJ
National Provider Identifier
1285445833
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 44SL07237900
- Practice address
- 14 Whittier Ave
Moorestown, NJ 08057-1531 - Phone
- (609) 321-4966
- NPI assigned
- Jan 14, 2025
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 44SL07237900 | NJ | Primary |
Addresses
Primary practice location
14 Whittier Ave
Moorestown, NJ 08057-1531
Mailing address
14 Whittier Ave
Moorestown, NJ 08057-1531
Phone (609) 321-4966
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 44SL07237900 | NJ | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1736812800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1736812800000",
"number": "1285445833",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 WHITTIER AVE",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080571531",
"telephone_number": "609-321-4966"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14 WHITTIER AVE",
"city": "MOORESTOWN",
"state": "NJ",
"postal_code": "080571531",
"telephone_number": "609-321-4966"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRY",
"first_name": "MIKAELA",
"middle_name": "TEEL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-01-14",
"last_updated": "2025-01-14",
"certification_date": "2025-01-14",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NJ",
"license": "44SL07237900",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moorestown, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.