Theresa Fry, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

6401009029 Issued in MI

Practice address

4870 W Clark Rd Ste 100
Ypsilanti, MI 48197-1104

Phone

(734) 219-5739

NPI assigned

May 3, 2023

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

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Midwest Wellness LLCGroup PAC ID 9133567829, 5 clinicians

Practice addresses (Care Compare)

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 and National Provider Directory roles.

• Midwest Wellness LLC

  • Mental Health Counselor
  • Niles, MI
  • NPI 1134625007
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1683072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683072000000",
    "number": "1396434643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6806 POPLAR DR",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971766",
            "telephone_number": "734-502-2186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4870 W CLARK RD STE 100",
            "city": "YPSILANTI",
            "state": "MI",
            "postal_code": "481971104",
            "telephone_number": "734-219-5739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "THERESA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-05-03",
        "last_updated": "2023-05-03",
        "certification_date": "2023-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MI",
            "license": "6401009029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jejuan Quintel French
• Fresh Start Clubhouse, Inc.
• Nathaniel Friedman
• Jennifer Fritz, LMSW
• Margaret Theresa Fry, LPN
• Allison Frymier
• Laura Renee Fucek, LMSW
• David J Fugenschuh, M.D.
• Barry R Fuller, M.D.
• Nancy Anne Fuller, OTR

• Professional Counselor in Ypsilanti, MI
• Providers in Ypsilanti, MI by specialty
• Professional Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 3, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.