Provider Demographics
NPI:1801364088
Name:FREY, CARLY F (LPCC)
Entity Type:Individual
Prefix:MISS
First Name:CARLY
Middle Name:F
Last Name:FREY
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3671 DUFFIELD RD
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-6543
Mailing Address - Country:US
Mailing Address - Phone:614-989-8805
Mailing Address - Fax:
Practice Address - Street 1:3671 DUFFIELD RD
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-6543
Practice Address - Country:US
Practice Address - Phone:614-989-8805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-06
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.2203076101YM0800X
OHCDCA.167034171M00000X
OHC.2002558101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator