Stacia Lea Fridley, LLMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

6801087255 Issued in MI

Practice address

901 Eastern Ave NE
Grand Rapids, MI 49503-1201

Phone

(616) 818-4819

Fax

(616) 284-3263

NPI assigned

Apr 1, 2011

Last updated

Apr 1, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Counseling Center of West Michigan, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1437610730
  Medicare reassignment NPD
• Pine Rest Christian Mental Health Services

  • Social Worker
  • Grand Rapids, MI
  • NPI 1922019157
  Medicare reassignment NPD
• Bright Aura Therapy and Wellness

  • Social Worker
  • Grand Rapids, MI
  • NPI 1023859352
  NPD Authorized official
• Pine Rest Christian Mental Health Services

  • Professional Counselor
  • Grand Rapids, MI
  • NPI 1386015683
  NPD
• Virtuwell Therapy, LLC

  • Mental Health Counselor
  • Grand Rapids, MI
  • NPI 1871356212
  NPD (past)

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

{
    "created_epoch": "1301616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301616000000",
    "number": "1386933190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 EASTERN AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031201",
            "telephone_number": "616-818-4819",
            "fax_number": "616-284-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 EASTERN AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495031201",
            "telephone_number": "616-818-4819",
            "fax_number": "616-284-3263"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLEY",
        "first_name": "STACIA",
        "middle_name": "LEA",
        "credential": "LLMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-01",
        "last_updated": "2011-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "MI",
            "license": "6801087255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tomas Frezghi
• Ashley Friar
• Deanne Marie Friar, MA,CCC-SLP
• Erin Michelle Fricke, M.D.
• Heather Leigh Fricke
• Emily Ann Friedl, DO
• Bradley Neal Friedland, D.O.
• Hanali Friedli, DLLP
• Lucas Patrick Friedli, DO
• Nicholas Friedli

• Social Worker in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Social Worker in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.