MEDICARE: NICOLE FRYLING LLPC

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	101YP2500X	Professional Counselor	6401017005	MI

General Provider Information

NPI Number	:	1861012940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NICOLE FRYLING LLPC

Provider Business Mailing Address
First Line	:	1865 GEORGETOWN CENTER DR STE C
Second Line	:
City	:	JENISON
State	:	MI
Zip	:	49428-7146
Country	:	US
Telephone Number	:	616-229-2920
Fax Number	:

Provider Business Practice Location Address
First Line	:	1865 GEORGETOWN CENTER DR STE C
Second Line	:
City	:	JENISON
State	:	MI
Zip	:	49428-7146
Country	:	US
Telephone Number	:	616-229-2920
Fax Number	:

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

Provider Enumeration Date	:	04/20/2020
Last Update Date	:	09/08/2021

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Directions to “ NICOLE FRYLING LLPC” Practice Location

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