Individual
MRS. BRENDA BEARDEN FRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSSW, LCSW
Contact information
Practice address
903 FOREST ST, GEORGETOWN, TX 78626-5523
(512) 963-2236
Mailing address
101 BROAD VISTA CT, GEORGETOWN, TX 78628-8249
(512) 963-2236
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
25240
TX
1041C0700X
Clinical Social Worker
Primary
25240
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
071295202
—
TX
05
—
071295203
—
TX
01
—
87142Q
BCBS OF TEXAS
TX
Enumeration date
07/08/2005
Last updated
03/18/2025
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