Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Alyse Fandrich

Individual provider Professional Counselor · NPI 1508418203

Alyse Fandrich is a Mental Health Counselor in Baxley, Georgia. Qualified in 2014, 12 years ago. Licensed in Georgia.

Years since qualifying
12
Licensed in
GA
In the registry since
2019

Practice location Address checks out

755 S Main St
Baxley, GA 31513-0130
Phone: (912) 367-4614
Fax: (912) 367-9048
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Professional Counselor (primary) Taxonomy 101YP2500X · Licence LPC010854 (GA)

Record details

NPI number1508418203
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 12, 2019
Last updated in NPPESJuly 12, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyMENTAL HEALTH COUNSELOR
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Accepts Medicare assignment Not indicated

Other providers in Baxley