Healthcare Provider Details

I. General information

NPI: 1700107570
Provider Name (Legal Business Name): DANIEL CARL FRYE LMFT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/16/2010
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

304 BICKFORD ST
NEW LISBON WI
53950-1533
US

IV. Provider business mailing address

PO BOX 887
MARSHFIELD WI
54449-0887
US

V. Phone/Fax

Practice location:
  • Phone: 608-562-3976
  • Fax: 608-562-3975
Mailing address:
  • Phone: 715-384-7589
  • Fax: 715-384-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number830-124
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: