Kimberly Gould Fry, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

202865

Practice address

601 Farley Dr
Austin, TX 78753-3114

Phone

(704) 975-8613

NPI assigned

May 19, 2019

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jan 30, 2024 through Jan 30, 2028

Medicare enrollment (NPD)

Not 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.

• Autonomy Movement LLC

  • Marriage & Family Therapist
  • Austin, TX
  • NPI 1740847417
  NPD Authorized official
• Kim Gould Therapy PLLC

  • Marriage & Family Therapist
  • Austin, TX
  • NPI 1205493988
  NPD Authorized official

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

{
    "created_epoch": "1558224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629072000000",
    "number": "1740846310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6104 TOSCANA AVE",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787246249",
            "telephone_number": "512-387-1398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 FARLEY DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787533114",
            "telephone_number": "704-975-8613"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRY",
        "first_name": "KIMBERLY",
        "middle_name": "GOULD",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-19",
        "last_updated": "2021-08-16",
        "certification_date": "2021-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": "202865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Micheal Frost
• Natalie Williford Frost, MD
• Nicole Frost, MSPT
• FRWD Sports Therapy LLC
• David Eric Fry, ATC
• Liam McCoy Fry, MD
• Megan Fry, RN
• Sarah Fry, PMHNP-BC
• Sarah Frydman
• Priscilla Frye-Patch, PT, DPT

• Marriage & Family Therapist in Austin, TX
• Providers in Austin, TX by specialty
• Marriage & Family Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.