Provider Demographics
NPI:1073585592
Name:FRICKER-ELHAI, ADRIENNE E (PHD)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:E
Last Name:FRICKER-ELHAI
Suffix:
Gender:F
Credentials:PHD
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Other - Credentials:
Mailing Address - Street 1:2150 W CENTRAL AVE FL 2
Mailing Address - Street 2:PROMEDICA TCH CULLEN CENTER, CHS BLDG
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43606-3834
Mailing Address - Country:US
Mailing Address - Phone:419-291-7919
Mailing Address - Fax:419-479-3273
Practice Address - Street 1:2150 W CENTRAL AVE FL 2
Practice Address - Street 2:PROMEDICA TCH CULLEN CENTER, CHS BLDG
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-3834
Practice Address - Country:US
Practice Address - Phone:419-291-7919
Practice Address - Fax:419-479-3273
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2012-05-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH6575103TC2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
ND12200Medicaid
SD238934OtherMIDLANDS CHOICE
SDHP37521OtherHEALTHPARTNERS
SDP00013287OtherRR MEDICARE
SD1766590OtherARAZ/ AMERICA'S PPO
NE46022474352Medicaid
SD4996337OtherBLUE CROSS
SD57108C024OtherWPS TRICARE
MN040121002OtherPRIMEWEST
IA3989442Medicaid
SD412991032870OtherPREFERRED ONE
SD6551990Medicaid
MN044G1ELOtherCC SYSTEMS/ BLUE PLUS
SD28317OtherSANFORD HEALTH PLAN
SD441OtherDAKOTACARE
SD370624200OtherDEPT OF LABOR
MN483958700Medicaid
SD28317OtherSANFORD HEALTH PLAN
NE46022474352Medicaid