Individual provider Active NPI

Candice L Fry, LCSW

  • Clinical Social Worker
  • St George, UT
National Provider Identifier
1417533845
Registry record updated Mar 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12218246-3506 Issued in UT
Practice address
321 N Mall Dr Ste R123
St George, UT 84790-7350
Phone
(435) 705-8132
NPI assigned
Mar 24, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 12218246-3506 UT Primary

Addresses

Primary practice location

321 N Mall Dr Ste R123
St George, UT 84790-7350

Mailing address

3155 S Hidden Valley Dr Unit 289
Saint George, UT 84790-6975
Phone (435) 705-8132

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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

Enrollment IDStateProvider typePAC IDDetails
I20240722000403 UT Practitioner - Clinical Social Worker 8527504059 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12218246-3506UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Align Therapy and Coaching LLC Multi-Specialty CurrentSince Mar 15, 2023 Accepting new patients

Locations

321 N Mall Dr
Ste R123
St George, UT 84790
Phone (435) 705-8132

321 N Mall Dr
Ste R
St George, UT 84790
Phone (435) 773-2063

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1616544000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710374400000",
    "number": "1417533845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 S HIDDEN VALLEY DR UNIT 289",
            "city": "SAINT GEORGE",
            "state": "UT",
            "postal_code": "847906975",
            "telephone_number": "435-705-8132"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 N MALL DR STE R123",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847907350",
            "telephone_number": "435-705-8132"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "CANDICE",
        "middle_name": "L",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-24",
        "last_updated": "2024-03-14",
        "certification_date": "2024-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "12218246-3506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.