Individual provider Active NPI

Mary Alice Fruit, PSYD

  • Group Psychotherapy Psychologist
  • Fayetteville, NC
National Provider Identifier
1649200924
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Group Psychotherapy PsychologistTaxonomy code 103TP2701X
License
2082 Issued in NC
Practice address
2300 Ramsey St
Mental Health Service Line (116)
Fayetteville, NC 28301-3856
Phone
(910) 482-5078
Fax
(910) 482-5099
NPI assigned
Jul 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Development & Aging Psychologist 103TA0700X 2082 NC
Clinical Psychologist 103TC0700X 2082 NC
Psychologist 103T00000X 2082 NC
Group Psychotherapy Psychologist 103TP2701X 2082 NC Primary

Addresses

Primary practice location

2300 Ramsey St
Mental Health Service Line (116)
Fayetteville, NC 28301-3856

Mailing address

5737 Cherrystone Rd
Fayetteville, NC 28311-1374
Phone (910) 480-0113

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2082NCMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1151884800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1649200924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5737 CHERRYSTONE RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283111374",
            "telephone_number": "910-480-0113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 RAMSEY ST",
            "address_2": "MENTAL HEALTH SERVICE LINE (116)",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283013856",
            "telephone_number": "910-482-5078",
            "fax_number": "910-482-5099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUIT",
        "first_name": "MARY",
        "middle_name": "ALICE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-03",
        "last_updated": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "NC",
            "license": "2082",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "2082",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NC",
            "license": "2082",
            "primary": false
        },
        {
            "code": "103TP2701X",
            "taxonomy_group": "",
            "desc": "Psychologist, Group Psychotherapy",
            "state": "NC",
            "license": "2082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.