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ALYSE FANDRICH
NPI 1508418203
Counselor - Professional in Baxley, GA

Active since July 12, 2019PECOS Enrolled
755 S MAIN ST, BAXLEY, GA 31513(912) 367-4614(912) 367-9048 Get Directions Write a Review

NPPES record last updated: July 12, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alyse Fandrich NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALYSE FANDRICH (NPI 1508418203) is an individual professional provider in Baxley, Georgia, licensed in Georgia (LPC010854) and active in the NPI registry since July 2019. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1508418203
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameALYSE FANDRICH
Location Address755 S MAIN STBaxley, GA 31513-0130
Mailing Address755 S Main StBaxley, GA 31513-0130 · (912) 367-4614 · Fax (912) 367-9048
Phone(912) 367-4614
Fax(912) 367-9048
Sole ProprietorNo
Enumeration DateJuly 12, 2019
✔ NPI 1508418203 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in GA · LPC010854
755 S MAIN ST, Baxley, GA 31513
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Alyse Fandrich is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

APPLING COUNSELING CENTER
Community/Behavioral Health
755 S MAIN ST
BAXLEY, GA 31513
Appling County (912) 367-4614
MRS. BRENDA M. THOMPSON FNP
Nurse Practitioner
755 S MAIN ST
BAXLEY, GA 31513
Appling County (912) 705-2273
SOUTHERN PHARMACARE LLC
Pharmacy (Community/Retail Pharmacy)
755 S MAIN ST
BAXLEY, GA 31513
Appling County (912) 294-1684

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alyse Fandrich's NPI number?

The NPI number for Alyse Fandrich is 1508418203. It was assigned to this individual provider in the NPPES registry on July 12, 2019.

Where is Alyse Fandrich located?

Alyse Fandrich practices at 755 S Main St, Baxley, GA 31513. The listed phone number is (912) 367-4614.

What is Alyse Fandrich's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Alyse Fandrich enrolled in Medicare?

Yes. Alyse Fandrich is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Alyse Fandrich was last updated on July 12, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.