Provider Demographics
NPI:1881867265
Name:FRICKE, GINGER LEIGH (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:GINGER
Middle Name:LEIGH
Last Name:FRICKE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1005 MAY ST
Mailing Address - Street 2:P.O. BOX 154
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-9380
Mailing Address - Country:US
Mailing Address - Phone:231-838-1713
Mailing Address - Fax:
Practice Address - Street 1:1005 MAY ST
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-9380
Practice Address - Country:US
Practice Address - Phone:231-838-1713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-08
Last Update Date:2012-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010855441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical