Jean M Fredrickson, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

L3255 Issued in OR

Practice address

930 SW Abbey St
Newport, OR 97365-4820

Phone

(541) 574-1811

NPI assigned

May 8, 2012

Sex

Female

Sole proprietor

Yes

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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

• Hospice of Spokane

  • Community Based Hospice Care Agency
  • Spokane, WA
  • NPI 1760475255
  NPD (past)

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

{
    "created_epoch": "1336435200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1336435200000",
    "number": "1083973366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "930 SW ABBEY ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654820",
            "telephone_number": "541-574-1811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 SW ABBEY ST",
            "city": "NEWPORT",
            "state": "OR",
            "postal_code": "973654820",
            "telephone_number": "541-574-1811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDRICKSON",
        "first_name": "JEAN",
        "middle_name": "M",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-08",
        "last_updated": "2012-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OR",
            "license": "L3255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Creta Anne Frandsen, RN
• Rebecca Fransham, LCSW
• William Randolph Fraser, M.D.
• Fred Meyer Stores Inc
• Eric James Fredericks, CNA
• Ashlie Freeman, CRM-I
• Fresenius Medical Care Dialysis Services - Oregon, LLC
• Carolyn Frances Fry, QMHP
• Norman Todd Gale, PMHNP-BC
• Jeff J. Gardner, H.A.S.

• Clinical Social Worker in Newport, OR
• Providers in Newport, OR by specialty
• Clinical Social Worker in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.