Active NPI
Corey Ann Fredericks, LCSW
- Clinical Social Worker
- Reno, NV
National Provider Identifier
1306408174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 9316-C
- Practice address
- 725 Reeves Ave
Reno, NV 89503-3425 - Phone
- (775) 347-7866
- NPI assigned
- Jul 2, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 9316-C | NV | Primary |
Addresses
Primary practice location
725 Reeves Ave
Reno, NV 89503-3425
Mailing address
725 Reeves Ave
Reno, NV 89503-3425
Phone (775) 750-7547
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9316-C | NV | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1562025600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1772409600000",
"number": "1306408174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "725 REEVES AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895033425",
"telephone_number": "775-750-7547"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "725 REEVES AVE",
"city": "RENO",
"state": "NV",
"postal_code": "895033425",
"telephone_number": "775-347-7866"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKS",
"first_name": "COREY",
"middle_name": "ANN",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-07-02",
"last_updated": "2026-03-02",
"certification_date": "2026-03-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NV",
"license": "9316-C",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Reno, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.