Provider Demographics
NPI:1255963955
Name:FRYE, BETHANY JANE (LCSW, LCDC)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:JANE
Last Name:FRYE
Suffix:
Gender:F
Credentials:LCSW, LCDC
Other - Prefix:
Other - First Name:BETHANY
Other - Middle Name:JANE
Other - Last Name:BRUNELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1045 HEEP RUN
Mailing Address - Street 2:
Mailing Address - City:BUDA
Mailing Address - State:TX
Mailing Address - Zip Code:78610-5090
Mailing Address - Country:US
Mailing Address - Phone:254-231-1559
Mailing Address - Fax:
Practice Address - Street 1:2600 W STASSNEY LN
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78745-3401
Practice Address - Country:US
Practice Address - Phone:254-231-5159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX650411041C0700X, 104100000X, 1041C0700X
TX15499101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker