Beth Frederick, PSY D

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

04456 Issued in MD

Practice address

186 Thomas Johnson Dr Ste 204
Frederick, MD 21702-4478

Phone

(703) 795-0853

NPI assigned

Apr 15, 2015

Last updated

Feb 1, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Oct 1, 2024 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Frederick Psychotherapy LLC

  • Clinical Psychologist
  • Frederick, MD
  • NPI 1891401816
  NPD Authorized official

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

{
    "created_epoch": "1429056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1675209600000",
    "number": "1083000103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5864 WINTER OAKS PL",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217046872",
            "telephone_number": "703-795-0853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 THOMAS JOHNSON DR STE 204",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217024478",
            "telephone_number": "703-795-0853"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "BETH",
        "credential": "PSY D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-04-15",
        "last_updated": "2023-02-01",
        "certification_date": "2023-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MD",
            "license": "04456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Frederick Reflexology LLC (Frederick Reflexology)
• Frederick Renal Care LLC.
• Frederick Surgical Center, LLC
• Frederick Urology Associates PA
• Frederick Urosurgical Center LLC
• Frederick's Radiology & Diagnostic Center, LLC
• Fredericks Sport and Spine Clinic Inc
• Fredericktown Ambulatory Surgical Facility, Inc.
• Fredericktowne Eye Care John Higinbotham OD PA
• Free State Health and Wellness, LLC

• Clinical Psychologist in Frederick, MD
• Providers in Frederick, MD by specialty
• Clinical Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.