Active NPI
Necole W Fryar, MA, LPC
- Professional Counselor
- Converse, TX
National Provider Identifier
1861749574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 66851
- Practice address
- 9830 Appellate Way
Converse, TX 78109-1985 - Phone
- (210) 883-6287
- Fax
- (210) 305-5750
- NPI assigned
- Aug 13, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 66851 | TX | Primary |
Addresses
Primary practice location
9830 Appellate Way
Converse, TX 78109-1985
Mailing address
9830 Appellate Way
Converse, TX 78109-1985
Phone (210) 883-6287
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3051997-02 | Medicaid | TX | |
| 3455909-01 | Medicaid | TX |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 1, 2024 through May 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 66851 | TX | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Amazing Grace Counseling Services, PLLC | Past | Accepting new patients |
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.
-
- Adult Mental Health Clinic/Center
- Converse, TX
- NPI 1497151484
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344816000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1480550400000",
"number": "1861749574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9830 APPELLATE WAY",
"city": "CONVERSE",
"state": "TX",
"postal_code": "781091985",
"telephone_number": "210-883-6287",
"fax_number": "210-305-5750"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9830 APPELLATE WAY",
"city": "CONVERSE",
"state": "TX",
"postal_code": "781091985",
"telephone_number": "210-883-6287",
"fax_number": "210-305-5750"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRYAR",
"first_name": "NECOLE",
"middle_name": "W",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-08-13",
"last_updated": "2016-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "TX",
"license": "66851",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3051997-02",
"state": "TX"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3455909-01",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Converse, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2016; 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.