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General NPI Number Information
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NPI Number | 1124440698
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Entity Type | Individual
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Provider Name | ELISABETH FRICKE MSC, MA
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Gender | Female
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Dates
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Enumeration Date | 01/17/2014
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Last Update Date | 03/14/2018
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Provider Practice Location Address
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Address Line | 1512 US HIGHWAY 395 N SUITE 2
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City | GARDNERVILLE
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State | NV
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Zip | 89410-5282
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Country | US
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Telephone | 775-400-7241
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Fax | 775-782-8637
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Provider Business Mailing Address
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Address Line | 1255 CENTERVILLE LN # B
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City | GARDNERVILLE
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State | NV
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Zip | 89460-9730
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Country | US
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Telephone | 775-400-7241
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 00382LC
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | MI0549
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License Number State | NV
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