Heather Fredericks

Primary specialty

Social WorkerTaxonomy code 104100000X

License

P121495 Issued in NY

Practice address

565 Bay Rd
Queensbury, NY 12804-1443

Phone

(518) 321-1380

Fax

(518) 797-1599

NPI assigned

Jun 21, 2023

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

Medicare enrollment (NPD)

Not 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 and National Provider Directory roles.

• Adirondack Counseling Traci Phillips LCSW PLLC

  • Clinical Social Worker
  • Queensbury, NY
  • NPI 1548964745
  NPD

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687305600000",
    "number": "1306521778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "617 GANSEVOORT RD",
            "city": "SOUTH GLENS FALLS",
            "state": "NY",
            "postal_code": "128035735",
            "telephone_number": "518-409-6458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 BAY RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041443",
            "telephone_number": "518-321-1380",
            "fax_number": "518-797-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICKS",
        "first_name": "HEATHER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "P121495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Franco, PT
• Matthieu C Francois, LMSW
• Mark A Franklin, DDS
• Kathleen Ann Fraser, PT
• Suzanne Rowland Fraser, PSYD
• Taylor Freebern, PHARMD
• Katy L Fuller, LCSW-R
• Simone Furbert
• Nicole Gaibrois, O.D.
• Sheila Renee Galea, RN

• Social Worker in Queensbury, NY
• Providers in Queensbury, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2023; 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.