Healthcare Provider Details

I. General information

NPI: 1689746810
Provider Name (Legal Business Name): AARYN JONES FRICK LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 06/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 CYPRESS CREEK RD
SEVERNA PARK MD
21146-4050
US

IV. Provider business mailing address

8632 HOULTON HARBOUR
PASADENA MD
21122-2570
US

V. Phone/Fax

Practice location:
  • Phone: 443-261-5974
  • Fax:
Mailing address:
  • Phone: 254-749-4214
  • Fax: 302-651-4945

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number44SLO5416000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number10831
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number50916
License Number StateTX
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number20459
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: