MEDICARE: CANDY FRYE LMSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	075174	NY

General Provider Information

NPI Number	:	1346794518
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CANDY FRYE LMSW

Provider Business Mailing Address
First Line	:	624 RIVER RD
Second Line	:
City	:	NORTH TONAWANDA
State	:	NY
Zip	:	14120-6563
Country	:	US
Telephone Number	:	716-693-9961
Fax Number	:

Provider Business Practice Location Address
First Line	:	3635 BELL BLVD STE 203
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11361-2097
Country	:	US
Telephone Number	:	716-864-0614
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2016
Last Update Date	:	08/26/2025

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Directions to “ CANDY FRYE LMSW” Practice Location

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