Thaddeus Frye, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CSW.00001285 Issued in CO

Practice address

1320 Ithaca Dr
Boulder, CO 80305-6334

Phone

(130) 335-8950

NPI assigned

Apr 16, 2019

Sex

Male

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

Enrolled in CO

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

Clinical Social Worker

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Eandd, LLC

  • Clinical Social Worker
  • Boulder, CO
  • NPI 1528688140
  Medicare reassignment NPD

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

{
    "created_epoch": "1555372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658016000000",
    "number": "1770146680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1320 ITHACA DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056334",
            "telephone_number": "303-358-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 ITHACA DR",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803056334",
            "telephone_number": "130-335-8950"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1008 Depot Hill Rd # 201",
            "address_purpose": "LOCATION",
            "city": "Broomfield",
            "state": "CO",
            "postal_code": "800206723",
            "country_code": "US",
            "telephone_number": "303-358-9507",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FRYE",
        "first_name": "THADDEUS",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-04-16",
        "last_updated": "2022-07-17",
        "certification_date": "2022-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CO",
            "license": "CSW.00001285",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Front Range DMX
• Front Range Upper Extremity Rehab, LLC
• Front Range Wellness Center
• Kelsey Nicole Froom, DNP, PMHNP-BC
• Chip Frye
• Daniel Joel Frysh
• Quddus Fujita Maus, LPC
• Reina Fujita Maus, MA, LPCC
• Lorri J Fulkerson, M.D.
• Full Circle Wholeness, LLC

• Clinical Social Worker in Boulder, CO
• Providers in Boulder, CO by specialty
• Clinical Social Worker in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2022; 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.