Healthcare Provider Details

I. General information

NPI: 1235856428
Provider Name (Legal Business Name): JAMIE FRICKER MSW, LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JAMIE AIDT

II. Dates (important events)

Enumeration Date: 10/27/2022
Last Update Date: 09/09/2025
Certification Date: 09/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1017 MUSTANG TRL
HARKER HEIGHTS TX
76548-2475
US

IV. Provider business mailing address

1017 MUSTANG TRL
HARKER HEIGHTS TX
76548-2475
US

V. Phone/Fax

Practice location:
  • Phone: 419-544-0968
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number116742
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number2024045299
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: