Individual provider Active NPI

Kennetha Frye, PHD

  • Clinical Psychologist
  • Spring, TX
National Provider Identifier
1922551431
Registry record updated Apr 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
37099 Issued in TX
Practice address
2002 Timberloch PL Ste 200
Spring, TX 77380-1182
Phone
(281) 815-0899
NPI assigned
Aug 1, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X 37099 TX
Clinical Psychologist 103TC0700X 37099 TX Primary

Addresses

Primary practice location

2002 Timberloch PL Ste 200
Spring, TX 77380-1182

Mailing address

5510 S Rice Ave Apt 2316
Houston, TX 77081-2164
Phone (713) 309-0266

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20161108002551 TX Practitioner - Clinical Psychologist 7416236799 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
My Bright Future, LLCGroup PAC ID 0648537936, 5 clinicians

Practice addresses (Care Compare)

2626 S Loop W
Suite 430
Houston, TX 77054-2649
Phone (817) 706-8415

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Kennetha L. Fry PHD PLLC Current Accepting new patients
My Bright Future, LLC CurrentSince Apr 1, 2018 Accepting new patients
On Site Counseling,Inc. CurrentSince Sep 1, 2016 Accepting new patients
Deer Oaks Geriatric Services P C Clinical CurrentSince Apr 15, 2020 Accepting new patients
Supportive Care LLC Clinical CurrentSince Nov 15, 2017 Accepting new patients
Deer Oaks Mental Health Associates PC Clinical Past Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

2626 S Loop W
Ste 430
Houston, TX 77054
Phone (713) 333-3771

3007 Caroline St
Houston, TX 77004
Phone (713) 528-2328

825 W Kearney St
Mesquite, TX 75149
Phone (972) 288-7660

7272 Wurzbach Rd
Ste 706
San Antonio, TX 78240
Phone (210) 615-3401

Organizations & group practices 6

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": "1470009600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586822400000",
    "number": "1922551431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5510 S RICE AVE APT 2316",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770812164",
            "telephone_number": "713-309-0266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2002 TIMBERLOCH PL STE 200",
            "city": "SPRING",
            "state": "TX",
            "postal_code": "773801182",
            "telephone_number": "281-815-0899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRYE",
        "first_name": "KENNETHA",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-08-01",
        "last_updated": "2020-04-14",
        "certification_date": "2020-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "TX",
            "license": "37099",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "TX",
            "license": "37099",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spring, TX

Sources for this page

Verify at the official NPI Registry.