Michelle Nicole Fry, MA, CRC, LPC

Individual provider Active NPI Professional Counselor · Hillside, IL

NPI 1376936336 · NPPES record last updated Mar 13, 2015

Key facts

NPI
1376936336
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
178.009665 (IL)
Practice address
4110 Litt Dr
Hillside, IL 60162-1120
Phone
(708) 547-3560
NPI assigned
Mar 13, 2015
Sex
Female
Sole proprietor
No

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

LicenseStateTypeSpecialty
00116763ILMDCounselor
178.009665ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 00116763 IL
Professional Counselor 101YP2500X 178.009665 IL Yes

Addresses

Primary practice location

4110 Litt Dr
Hillside, IL 60162-1120

Mailing address

498 Thunderbird TRL
Carol Stream, IL 60188-1584
Phone (630) 347-2925

Other names

  • Ms. Michelle Nicole Ruff Former name

Other providers in Hillside, IL

All providers in Hillside, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.