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General NPI Number Information
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NPI Number | 1649294638
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Entity Type | Individual
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Provider Name | N. JOEL FRY LISW, LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/26/2006
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Last Update Date | 11/08/2025
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Provider Practice Location Address
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Address Line | 14424 KENNEDY ST
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City | INDIANOLA
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State | IA
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Zip | 50125-8251
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Country | US
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Telephone | 515-238-9010
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Fax | 641-342-1017
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Provider Business Mailing Address
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Address Line | 1473 195TH AVE
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City | OSCEOLA
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State | IA
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Zip | 50213-8222
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Country | US
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Telephone | 515-238-9010
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Fax | 641-342-1017
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 05713
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License Number State | IA
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