Individual provider Active NPI

Nancy Fridley

  • Counselor
  • Wooster, OH
National Provider Identifier
1912370826
Registry record updated Nov 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
E.0021590 Issued in OH
Practice address
104 Spink St
Wooster, OH 44691-3652
Phone
(330) 264-8498
NPI assigned
Nov 2, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X E.0021590 OH Primary

Addresses

Primary practice location

104 Spink St
Wooster, OH 44691-3652

Mailing address

104 Spink St
Wooster, OH 44691-3652

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240729003411 OH Practitioner - Mental Health Counselor 6103362983 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hope Behavioral Health LLCGroup PAC ID 9638471865, 20 clinicians

Practice addresses (Care Compare)

24100 Chagrin Blvd
Suite 330
Beachwood, OH 44122-5552
Phone (800) 642-4560

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
E.0021590OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope Behavioral Health LLC CurrentSince May 3, 2024 Accepting new patients

Locations

24100 Chagrin Blvd
Ste 330
Beachwood, OH 44122
Phone (800) 642-4560

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": "1446422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1446422400000",
    "number": "1912370826",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 SPINK ST",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "446913652",
            "telephone_number": "330-264-8498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRIDLEY",
        "first_name": "NANCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-11-02",
        "last_updated": "2015-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.0021590",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wooster, OH

Sources for this page

Verify at the official NPI Registry.