Provider Demographics
NPI:1336217355
Name:FRY, KAREN LEA (LCSW)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LEA
Last Name:FRY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:20 SILVERLEAF CT
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72210-4731
Mailing Address - Country:US
Mailing Address - Phone:501-425-2814
Mailing Address - Fax:501-441-6861
Practice Address - Street 1:2301 SPRINGHILL RD STE 200
Practice Address - Street 2:
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72019-7566
Practice Address - Country:US
Practice Address - Phone:501-425-2814
Practice Address - Fax:501-441-6861
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR2348-C1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical