Provider Demographics
NPI:1942338272
Name:FRY, ANGELA (LISW)
Entity Type:Individual
Prefix:MS
First Name:ANGELA
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6157
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43206-0157
Mailing Address - Country:US
Mailing Address - Phone:614-224-4663
Mailing Address - Fax:614-224-7222
Practice Address - Street 1:655 EAST MAIN STREET
Practice Address - Street 2:CHOICES
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43205
Practice Address - Country:US
Practice Address - Phone:614-224-4663
Practice Address - Fax:614-224-7222
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHI00082581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08258Medicare UPIN