Kevin Eugene Fraley Jr., LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH21975 Issued in FL

Practice address

4453 Highway 90
Pace, FL 32571-2066

Phone

(850) 905-0110

Fax

(850) 905-8600

NPI assigned

Mar 21, 2023

Last updated

Mar 21, 2023By the provider in NPPES

Sex

Male

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 FL

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, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Partners Family Medicine Practice and Recovery Center IncGroup PAC ID 6800213851, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Partners Family Medicine Practice & Recovery Center Inc

  • Addiction (Substance Use Disorder) Counselor
  • Pace, FL
  • NPI 1396364899
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1679356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679356800000",
    "number": "1619679644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4453 HIGHWAY 90",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712066",
            "telephone_number": "850-905-0110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4453 HIGHWAY 90",
            "city": "PACE",
            "state": "FL",
            "postal_code": "325712066",
            "telephone_number": "850-905-0110",
            "fax_number": "850-905-8600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRALEY",
        "first_name": "KEVIN",
        "middle_name": "EUGENE",
        "name_suffix": "Jr.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-03-21",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH21975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ryan Wesley Floyd, ARNP
• Kennedy Leigh Foote, MS
• Donna Forbes, ARNP
• Kaitlin Vansickle Forshee, D.M.D.
• Courtney Forst
• Freedom Fighters Therapy LLC
• Jenna Freeman, COTA/L
• Jennifer Freeman
• Margie Lynn Fretwell, LPN
• Alexis Elizabeth Fudge, RBT

• Mental Health Counselor in Pace, FL
• Providers in Pace, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 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.