Carrie E Frederick, M.S., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA7712 Issued in FL

Practice address

1619 Harden Blvd
Lakeland, FL 33803-1826

Phone

(863) 808-1970

NPI assigned

Jan 29, 2007

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

Other names 1

• Carrie E Frederick Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697414400000",
    "number": "1306982178",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031826",
            "telephone_number": "863-808-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 HARDEN BLVD",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338031826",
            "telephone_number": "863-808-1970"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREDERICK",
        "first_name": "CARRIE",
        "middle_name": "E",
        "credential": "M.S., CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-29",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA7712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CARRIE",
            "last_name": "FREDERICK",
            "middle_name": "E",
            "credential": "M.S., CCC-SLP",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jennifer Glisson Frasier, APRN
• Madeline Marie Frasik, MA, BCBA
• Mary W Frates, OD
• Richard E Frates, MD
• Darvis T. Frazier, PH.D.
• Caitlin R. Fredericka
• Catherine Elizabeth Fredericks, PHARM D, RPH
• Mary Freeman
• Victoria Freeman, LMHC
• Shelley A Friedland, PT

• Speech-Language Pathologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 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.