Provider Demographics
NPI:1801104658
Name:FRYE, NICHOLAS DREW (LCPC)
Entity type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:DREW
Last Name:FRYE
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10824 MIDDLEBORO DR
Mailing Address - Street 2:
Mailing Address - City:DAMASCUS
Mailing Address - State:MD
Mailing Address - Zip Code:20872-2250
Mailing Address - Country:US
Mailing Address - Phone:240-687-7472
Mailing Address - Fax:
Practice Address - Street 1:700 MONTCLAIRE AVE
Practice Address - Street 2:SUITE C
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21701-4577
Practice Address - Country:US
Practice Address - Phone:240-464-8000
Practice Address - Fax:240-383-3439
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3344101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional