Emily M Fredericks, PHD

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

6301012365 Issued in MI

Practice address

1500 E Medical Center Dr
Ann Arbor, MI 48109-5000

Phone

(734) 936-4000

NPI assigned

Aug 21, 2006

Last updated

Oct 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Regents of the University of MichiganGroup PAC ID 3779496856, 3,344 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Michigan Health System Hospital, Ann Arbor, MI, CCN 230046

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Regents of the University of Michigan

  • Psychologist
  • Ann Arbor, MI
  • NPI 1568487130
  Medicare reassignment Care Compare group
• Regents of the University of Michigan

  • Home Health Agency
  • Ann Arbor, MI
  • NPI 1063465607
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Regents of the University of Michigan

  dba University of Michigan Health System

  • General Acute Care Hospital
  • Ann Arbor, MI
  • NPI 1003878539
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1033225420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 S STATE ST",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481081633",
            "telephone_number": "734-647-5299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 E MEDICAL CENTER DR",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481095000",
            "telephone_number": "734-936-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "EMILY",
        "middle_name": "M",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MI",
            "license": "6301012365",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MI",
            "license": "6301012365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Fraus, LMSW
• Meghan Frazho, LLMSW
• Lauren Eileen Frazier, MS, LCGC
• Fred W. Stelson, M.D. PLC
• Elizabeth Ann Frederick, LMSW
• Barbara Fredrick, NURSE PRACTITIONER
• Kristine Ellen Freeark-Zucker, PH.D.
• Darren Patrick Freeland, PA
• Carol Margaret Freeman, NP
• Erin Freeman, LMSW

• Clinical Child & Adolescent Psychologist in Ann Arbor, MI
• Providers in Ann Arbor, MI by specialty
• Clinical Child & Adolescent Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.