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NPI Code Detail

MEDICARE: LAKYN FRYE MSW, LCAS, LCSW-A

MEDICARE:   LAKYN  FRYE  MSW, LCAS, LCSW-A
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerP019859NC
2101YA0400XAddiction (Substance Use Disorder) CounselorLCAS-28895NC

General Provider Information

NPI Number : 1790514487
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAKYN FRYE MSW, LCAS, LCSW-A
Provider Business Mailing Address
First Line : 1625 S 17TH ST APT 365
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-6573
Country : US
Telephone Number : 757-969-3848
Fax Number :
Provider Business Practice Location Address
First Line : 2520 TROY DR
Second Line :
City : WILMINGTON
State : NC
Zip : 28401-7643
Country : US
Telephone Number : 910-762-2727
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/30/2024
Last Update Date : 07/30/2024

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Directions to “ LAKYN FRYE MSW, LCAS, LCSW-A” Practice Location

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