Individual provider Active NPI

Brett Lee Fries, LIMHP

  • Mental Health Counselor
  • Kearney, NE
National Provider Identifier
1679996342
Registry record updated Nov 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1426 Issued in NE
Practice address
2811 30TH Ave
Kearney, NE 68845-4036
Phone
(083) 237-6865
Fax
(308) 236-7698
NPI assigned
Jan 30, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2020

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 9963 NE
Mental Health Counselor 101YM0800X 4506 NE
Psychologist 103T00000X 4506 NE
Mental Health Counselor 101YM0800X 1426 NE Primary

Addresses

Primary practice location

2811 30TH Ave
Kearney, NE 68845-4036

Mailing address

2811 30TH Ave
Kearney, NE 68845-4036
Phone (308) 237-6865

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NE
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
I20240119000253 NE Practitioner - Mental Health Counselor 9830541432 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Kearney Counseling Associates LLC 4 clinicians

Practice addresses (Care Compare)

2811 30TH Ave
Kearney, NE 68845-4036
Phone (308) 237-6865

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4506NEMDPsychologist
1426NEMDMarriage & Family Therapist
9963NEMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Kearney Counseling Associates LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2811 30th Ave
Kearney, NE 68845
Phone (308) 237-6865

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": "1391040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605571200000",
    "number": "1679996342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 30TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688454036",
            "telephone_number": "308-237-6865",
            "fax_number": "308-236-7698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 30TH AVE",
            "city": "KEARNEY",
            "state": "NE",
            "postal_code": "688454036",
            "telephone_number": "083-237-6865",
            "fax_number": "308-236-7698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIES",
        "first_name": "BRETT",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "LIMHP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-30",
        "last_updated": "2020-11-17",
        "certification_date": "2020-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "9963",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "4506",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NE",
            "license": "4506",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NE",
            "license": "1426",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kearney, NE

Sources for this page

Verify at the official NPI Registry.