Individual provider Active NPI

Sarah Lynne Fredericks, LCSW-R

  • Clinical Social Worker
  • Utica, NY
National Provider Identifier
1285924423
Registry record updated Jul 16, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
082826 Issued in NY
Practice address
1002 Oswego St
Utica, NY 13502-5031
Phone
(315) 798-8868
NPI assigned
Apr 8, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 16, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 081945-1 NY
Clinical Social Worker 1041C0700X 082826 NY Primary

Addresses

Primary practice location

1002 Oswego St
Utica, NY 13502-5031

Mailing address

1 Kellogg Rd
New Hartford, NY 13413-2824
Phone (315) 723-8118

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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

Enrollment IDStateProvider typePAC IDDetails
I20150714000031 NY Practitioner - Clinical Social Worker 1052624509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Upstate Cerebral Palsy IncGroup PAC ID 5496734758, 30 clinicians

Practice addresses (Care Compare)

1601 Armory Dr
Utica, NY 13501-5405
Phone (315) 798-8868

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
081945-1NYMDClinical Social Worker
082826NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Upstate Cerebral Palsy, Inc. CurrentSince Apr 1, 2015 Accepting new patients
Upstate Cerebral Palsy, Inc CurrentSince Apr 1, 2015 Accepting new patients

Locations

1601 Armory Dr
Utica, NY 13501
Phone (315) 798-4006

1427 Genesee St
Utica, NY 13501
Phone (315) 738-1428

1002 Oswego St
Utica, NY 13502
Phone (315) 798-8868

125 Business Park Dr
Utica, NY 13502
Phone (315) 724-6907

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1302220800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752624000000",
    "number": "1285924423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 KELLOGG RD",
            "city": "NEW HARTFORD",
            "state": "NY",
            "postal_code": "134132824",
            "telephone_number": "315-723-8118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1002 OSWEGO ST",
            "city": "UTICA",
            "state": "NY",
            "postal_code": "135025031",
            "telephone_number": "315-798-8868"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "SARAH",
        "middle_name": "LYNNE",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-08",
        "last_updated": "2025-07-16",
        "certification_date": "2025-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "081945-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "082826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Utica, NY

Sources for this page

Verify at the official NPI Registry.