Provider Demographics
NPI:1962680140
Name:FRY, CORA KAY (LPC)
Entity Type:Individual
Prefix:
First Name:CORA
Middle Name:KAY
Last Name:FRY
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:ELLEN
Other - Last Name:MCKEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPC
Mailing Address - Street 1:1620 ELTON RD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20903-1740
Mailing Address - Country:US
Mailing Address - Phone:301-439-7191
Mailing Address - Fax:301-439-1169
Practice Address - Street 1:7100 ALASKA AVE NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-1544
Practice Address - Country:US
Practice Address - Phone:301-439-7191
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-09
Last Update Date:2008-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCPRC13960101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional