Individual provider Active NPI

Steven R Fricke

  • School Psychologist
  • North Canton, OH
National Provider Identifier
1801255427
Registry record updated Feb 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
School PsychologistTaxonomy code 103TS0200X
License
OT1000671 Issued in OH
Practice address
239 Portage St. NE
North Canton, OH 44720
Phone
(330) 497-5665
NPI assigned
Feb 11, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 11, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
School Psychologist 103TS0200X OT1000671 OH Primary

Addresses

Primary practice location

239 Portage St. NE
North Canton, OH 44720

Mailing address

721 Donner Ave SW
North Canton, OH 44720-2931
Phone (330) 417-0462

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
OT1000671OHMDSchool Psychologist

NPI Registry JSON

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1801255427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "721 DONNER AVE SW",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "447202931",
            "telephone_number": "330-417-0462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "239 PORTAGE ST. NE",
            "city": "NORTH CANTON",
            "state": "OH",
            "postal_code": "44720",
            "telephone_number": "330-497-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRICKE",
        "first_name": "STEVEN",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "OH",
            "license": "OT1000671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.