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NPI Code Detail

MEDICARE: KEVIN WAYNE FRICK LPCC

MEDICARE: KEVIN WAYNE FRICK LPCC
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
1101YM0800XMental Health CounselorCTB-2025-0299NM

General Provider Information

NPI Number : 1780197244
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN WAYNE FRICK LPCC
Provider Business Mailing Address
First Line : 1312 NAKOMIS DR NE UNIT H
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87112-6041
Country : US
Telephone Number : 304-627-5556
Fax Number :
Provider Business Practice Location Address
First Line : 1031 LAMBERTON PL NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87107-1641
Country : US
Telephone Number : 505-272-0371
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2017
Last Update Date : 12/15/2025

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Directions to “ KEVIN WAYNE FRICK LPCC” Practice Location

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